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Treatment for Congenital Megacolon or Congenital Aganglionic Megacolon

Congenital megacolon or congenital aganglionic megacolon occurs due to the genetic defects in the babies. Surgery is performed to eliminate the diseased portion of the intestine so that the passage of the stool is clear. Although the babies would get relief, the symptoms might last for some time.

Treatment for Congenital Megacolon or Congenital Aganglionic Megacolon

In this article you will learn about the treatment for congenital megacolon or congenital aganglionic megacolon, risk factor and complications in congenital megacolon or congenital aganglionic megacolon.

Treatment for Congenital Megacolon or Congenital Aganglionic Megacolon

Surgery to Treat Congenital Megacolon or Congenital Aganglionic Megacolon

Surgery is the main mode of treatment for congenital megacolon or congenital aganglionic megacolon. Surgery is used to eliminate the infected portion of the colon which is devoid of the nerve cells. Linings of infected portion are removed and the healthy part is directly joined to the rectum. Surgeons are using Laparoscopic technique to accomplish the task.

Babies children and with advanced stage of congenital megacolon or congenital aganglionic megacolon undergo operation in two stages:

The disease part is eliminated and the rest is tied to a small hole called as ostomy which is created in the abdomen of the baby. Stool is directed to the ostomy which sends it to the bag attached to the intestine. The process helps the colon to recuperate over a period of time.

Under the ostomy process for congenital megacolon or congenital aganglionic megacolon, the following steps are taken:

  • In the ileostomy process, the whole colon is eliminated and the stool is passed through the small intestines‘ end.
  • In the colostomy process, the healthy part of the colon is left by the doctors while the stool is routed through the large intestine.
  • At last, the hole or the ostomy is closed and the intestine is connected to the anus.

In some children, the colon or the small intestine might get affected. In such cases, the damaged colon is stripped off and the healthy portion is connected to the anus.

Results of Surgery for Congenital Megacolon or Congenital Aganglionic Megacolon

Once the surgery for congenital megacolon or congenital aganglionic megacolon is completed, the children can pass the stool normally or they might also face the problem of Diarrhea. Toilet training might require lot of time because the kids might suffer from swollen belly and leaking stool. Even after the operation, the children would suffer from constipation for a significant amount of time. Initially, the babies may develop infection after surgery. Different symptoms of enterocolitis that immediately require the attention of the doctors are as follows:

  • Rectum infection and bleeding
  • Acute diarrhea
  • Acute fever
  • Increase in the size of the abdomen
  • Continuous vomiting.

Complications after the Surgery for Congenital Megacolon or Congenital Aganglionic Megacolon

  • Inflammation along with infection can occur in the intestine after the congenital megacolon or congenital aganglionic megacolon surgery during initial period. The symptoms are acute as they include the distension of the abdomen followed by smelly diarrhea and poor appetite.
  • Intestines can also get ruptured or perforated after surgery for congenital megacolon or congenital aganglionic megacolon.
  • The short bowel symptoms could result in severe malnourishment along with dehydration.

Diet and Activity after the Congenital Megacolon or Congenital Aganglionic Megacolon

The baby should not be given any food for few hours after surgery for congenital megacolon or congenital aganglionic megacolon. After the operation is conducted the intravenous fluids are injected into the patient along with antibiotics however the baby or the child should not have any solid food, till the bowel function is stabilized. In case of diverting colostomy, the passage of the stool should be restored before proceeding with the feeding procedures.

Once the bowel function kicks in, the patient could be administered tube feeding or the breast milk. Liquid is provided orally and the infant can continue to feed to gain essential nutrients. Once the colostomy is performed, it is vital to provide food after 48 hours. If the feeding returns to normal, the patient can be discharged without any problem. It is important to provide diet consisting of high fiber components. Therefore, the patient should consume fresh fruits and vegetables.

Physical activities need to be controlled so that the colon is healed in a proper manner.

Outpatient Monitoring for Congenital Megacolon or Congenital Aganglionic Megacolon

Pull through procedure for congenital megacolon or congenital aganglionic megacolon plays a very important role in benefitting the health of the patients. As a result the kids can grow in a normal manner. Bowel habit of the child needs to be monitored on a regular basis. If the surgery is not followed by complications, the colon would heal however the bowel functions might take a long time before it could be stabilized.

Once the surgery is performed, the patient may face gastrointestinal problems on a regular basis. One of the common problems such as hypomotility can infect the patient and it should be treated with the help of the laxatives. Kids who face difficulties in passing stool should prescribe to the enema treatment.

Medications to Treat Congenital Megacolon or Congenital Aganglionic Megacolon

Medication treatment is carried out to eliminate the infection and complications from long terms perspective.

Diverting colostomy is followed by the pull through surgery to provide relief to the patients with congenital megacolon or congenital aganglionic megacolon. Intravenous antibiotics are administered to the kids so that the bowel function attains normalcy. Once the child is able to get the liquid and the solid feed, the medication can be withdrawn.

Counseling for Congenital Megacolon or Congenital Aganglionic Megacolon

Once the operation for treating congenital megacolon or congenital aganglionic megacolon is performed, the physician should advise the parents to provide fiber rich diet to the kid because in absence of fresh fruits and vegetables the child might contact enterocolitis. Doctors need to provide information about the conditions that might arise in congenital megacolon or congenital aganglionic megacolon patients. Parents need to take extra caution when they are planning for the siblings because they might also suffer from similar disorder. A hand out is provided along with the article to educate people about congenital megacolon or congenital aganglionic megacolon.

Risk Factors for Congenital Megacolon or Congenital Aganglionic Megacolon

Numerous risk factors can lead to the onset of congenital megacolon or congenital aganglionic megacolon

  • Having a brother or sister who has congenital megacolon or congenital aganglionic megacolon. CAM is a genetic disorder, therefore siblings might contact the disease
  • Being male. Frequency of congenital megacolon or congenital aganglionic megacolon is high in males.
  • Having other genetic conditions. Congenital megacolon or congenital aganglionic megacolon can occur due to genetic conditions including heart problems and the Down syndrome. Sometimes people suffering from endocrine Neoplasia or benign tumors can get affected with the disease. Sometime cancer of the thyroid gland could be the cause of congenital megacolon or congenital aganglionic megacolon. Majority of children suffering from the issue also face the onset of different diseases.

Complications in Congenital Megacolon or Congenital Aganglionic Megacolon

The major complication for the babies and kids with congenital megacolon or congenital aganglionic megacolon is the problem of enterocolitis.

When the stool is accumulated in the colon, it may cause the above mentioned problem. Over a period of time, the bacteria thrive and spread to other parts of the body. The stool increases in mass and enhances the pressure on the blood vessels. As the blood supply is blocked, the colon malfunctions and becomes immune to infection. The disease can prove to be fatal for the patients. Therefore, it is important to carry out colon cleaning and use the antibiotics.

References:

  1. Cleveland Clinic. (2021). Hirschsprung’s Disease (Aganglionosis). Cleveland Clinic. Link

Also Read:

Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:August 29, 2023

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