Bowel function,mental health,and psychosocial function in adolescents with Hirschsprung's disease

Accepted 2 September 1996
Congenital intestinal malformations are uncommon and may poselasting somatic difficulties. Patients with anorectal anomalies have ahigh frequency of persistent faecal dysfunction and psychosocial problems. This study examined whether adolescents with Hirschsprung''s disease have more psychosocial problems than their healthy peers. Nineteen adolescents (mean age 15.7 years) with Hirschsprung''s diseasewere assessed for bowel function, anorectal physiology, mental health,and psychosocial functioning by physical examinations, semistructuredinterview, and standardised questionnaires. The adolescents werecompared with controls. The parents of 13 adolescents withHirschsprung''s disease were interviewed and completed questionnaires. Thirty two per cent of the adolescents with Hirschsprung''s disease hadsignificant impairment of continence, but no more psychopathology (16%) nor psychosocial dysfunction as a group than their healthy peers. Faecal incontinence was associated with poorer psychosocial functioning and parental criticism. The fact that a significant numberof patients with Hirschsprung''s disease have incontinence intoadulthood indicates the need for parental counselling, encouraging realistic expectations about continence.