ArticlePediatric surgery international2025
Beyond Hirschsprung: outcomes of symptomatic infants after exclusion of Hirschsprung disease on rectal suction biopsy.
Article in Pediatric surgery international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeRectal suction biopsies (RSB) to exclude Hirschsprung disease (HD) are performed on a low threshold in infants with defecation problems. This leads to a significant number of symptomatic infants with excluded HD. We intend to characterize them and provide a perspective on their clinical outcome.
methodsA retrospective chart review was performed in 90 infants who underwent RSB at our institution from 2011 to 2022. In 54 infants, HD was excluded. Thirty one of those infants met the inclusion criteria and were further analyzed.
resultsTreatment was initiated prior to biopsies with rectal irrigations in 71% (n = 22), suppositories in 3% (n = 1), oral laxatives in 23% (n = 7), and dietary modifications in 3% (n = 1). At last follow-up, 81% (n = 25) of patients had no further need for treatment, and 19% still regularly used oral laxatives or suppositories (n = 6). In three patients, another gastroenterological diagnosis was found. Four patients were re-referred to the gastroenterological clinic later in childhood.
conclusionDefecation problems in early infancy will resolve in most patients with excluded HD without any further treatment. However, some patients will continue to have gastrointestinal symptoms and may need to take laxatives long-term.
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