September 26, 2008

Intestinal Disease Leads to Embarrassing Fecal Leakage


Dear Dr. Gott: My 10-year-old grandson had corrective surgery for Hirschsprung's disease when he was an infant. He has been experiencing fecal leakage since then. He gets quite embarrassed, but he can't keep from having "accidents." I was wondering if Kegel exercises would be of benefit to him. Any help you can offer would be appreciated.

Dear Reader: Hirschsprung's disease is a condition of the large intestine. It causes problems with passing stool because of missing nerve cells in the intestinal muscles. It is present from birth (congenital) and has no known cause.

Hirschsprung's disease occurs in one out of every 5,000 births and ranges from mild to severe. The condition is five times more common in boys and sometimes is associated with other congenital disorders, such as Down syndrome.

Hirschsprung's disease develops while the baby is still in the womb. At some point during development of the colon, the nerve bundles that line it fail to form. This can occur throughout the entire large intestine or just a few centimeters up from the rectum. The longer the affected area, the worse symptoms tend to be. It is not caused by anything the expectant mother has done or not done.

The only treatment is surgical removal of the affected area of colon. You stated your grandson has already had this surgery. I suspect his fecal leakage was caused by the surgery, which carries the risk of muscle, rectal and nerve damage. I urge your grandson's parents to talk to his gastroenterologist to see whether there is anything that can be done. Older people can be helped by medication, surgery or surgical implants. At the appointment to discuss the leakage, Kegel exercises can be brought up as a possible aid. I am not sure they will be effective, but they can't do any harm.

Write Dr. Gott c/o United Media, 200 Madison Ave. 4th floor, New York, NY 10016.

Originally published by PETER GOTT Newspaper Enterprise Association.

(c) 2008 Tulsa World. Provided by ProQuest LLC. All rights Reserved.