Male2: …but you might not have the right nerve cells in your rectum, then you have a fancy name, Hirschsprung’s disease. That needs surgery. Today, we usually operate one stage. We can use minimally invasive techniques, the baby hardly has a--
Male1: Now, you say Hirschsprung’s disease. That means, there is a bowel, but you said nerves. I mean, the electrical system is suddenly like missing?
Male2: Yes, because the bowels are like the heart. They do not just have a wall, but they have a muscle system and nerves that propel and in Hirschsprung’s disease, you do not have those nerves down in the rectum that would push things out. So the bowels are blocked.
Male1: Does it involve a little area or a big area or a variation?
Male2: It usually involves a little area and it can involve a big area.
Male1: And that one you have to remove the bowel that has obviously no electrical systems to make it work, is that correct?
Male2: And the surgeon does some fancy reconstruction, you really need a pediatric surgeon who knows how to get the bowel with nerve cells down to replace that rectum that has no nerve cells.
Male1: And also that for years afterwards, you would be careful because sometimes, it could be a little bit of constipation problems and things like that could happen afterwards.
Male2: That kind of baby needs lifelong follow up of a pediatric surgeon and in cahoots with the pediatrician. The life threatening part of that disease is called enterocolitis and that can happen after the surgery where the baby gets very listless, looks like they are in shock, maybe has some diarrhea and that baby needs emergency treatment with gastric tube, a fluid by vein, antibiotics, washing out of the bowels.
Male1: But that is not a common thing.
Male2: Entero colitis happens--
Male1: It happens, but when we do the surgery and it is followed carefully, we minimize that risk to some point.
Male2: That is true.
Male1: So we have to follow it very carefully.
Male2: That is true. I am going to hold to my ground that the thing that parents and pediatricians need to know about Hirschsprung’s is the risk that life long risk and they have to know the early warning signs.
Male1: So basically, good education, good follow up always is the best thing to do is that correct?
Male2: It is correct.
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