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EUPSA/ERNICA
Hirschsprung-associated enterocolitis in children: An ERNICA animation for parents and families
Chapter 1 of 5 · Fundamentals
HAEC definition
Definition and pathophysiology of Hirschsprung-associated enterocolitis
Expert statements on this page
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Host summaries · secondary, not cited in answers
Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
Enterocolitis is an inflammation of the intestine that occurs when the body does not get rid of poop quick enough
A blockage forms in the large intestine, which causes it to swell
Bacteria grows and enters the blood vessels in enterocolitis
In rare cases, a bowel perforation can occur, which is when a hole develops on the wall of the large intestine due to pressure
Signs and symptoms of enterocolitis may include smelly explosive poop, which may sometimes contain blood, a swollen and painful belly, nausea and or vomiting, and fever
Signs of dehydration in enterocolitis include a lack of activity and reduced urination
Up to 40-50% of children with Hirschsprung's disease experience enterocolitis, either before or after surgical correction
Enterocolitis is more common after surgical correction in Hirschsprung's disease
For a small number of children, enterocolitis can be persistent and occur repeatedly throughout their life
Hirschsprung associated enterocolitis can be triggered by various different factors, such as a virus, bacterial infection, or intestinal dysbiosis
To treat symptoms of enterocolitis in children, it is very important to remove the blockage of poop in the large intestine
Irrigation to remove blockage is done using a special tube called a rectal cannula
If enterocolitis becomes a repeated problem, the clinical team may teach families how to carry out irrigation at home
Symptoms of dehydration can be treated with a drinkable rehydration solution or where necessary, fluid can be given through a vein
Blood infections must be prevented using antibiotic medication in enterocolitis
When symptoms have improved, it is important for the clinical team to investigate possible triggers and underlying causes of the enterocolitis
Enterocolitis may be caused by obstruction due to bowel dysfunction or by the anatomy of the remaining bowel after the pull-through operation
Children with Hirshsprung's disease often experience difficulties getting rid of poop because of tight sphincter muscles in the anus
There can be behavioral and psychological causes of enterocolitis in Hirschsprung's disease
Possible treatment for underlying causes includes support with bowel management, internal Botox injections, and in some cases, surgery
Structured regular follow-up care by a team of different clinical specialists is essential for children with Hirschsprung's disease, ideally by a multidisciplinary team
Identifying any complications or difficulties early is very important in Hirschsprung's disease
Even if a child has symptoms of enterocolitis after corrective surgery for Hirschprung's disease, these can improve as they grow older