Letters Hirschsprung’s disease

Anorectal function is not always normal after surgery in Hirschsprung’s disease

BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e8192 (Published 03 December 2012) Cite this as: BMJ 2012;345:e8192
  1. David Wilkinson, speciality registrar in paediatric surgery1,
  2. Simon Kenny, consultant paediatric surgeon1
  1. 1Alder Hey Children’s Hospital NHS Foundation Trust, Liverpool L12 2AP, UK
  1. d.wilkinson1{at}mac.com

Arshad and colleagues highlight that, although rare, late presenting Hirschsprung’s disease in children can result in serious morbidity.1 However, their statement that most patients with Hirschsprung’s disease have “near normal anorectal function after surgery” is misleading.

A recent Finnish population based cross sectional study of adults with Hirschsprung’s disease found that only 47% had a normal bowel function score,2 a result that is consistent with English studies using the same scoring system.3 Furthermore, up to 48% of adults report occasional soiling, with 14% experiencing potentially socially disabling faecal incontinence.2

Although most patients with Hirschsprung’s disease learn to actively manage their bowels and report adequate quality of life scores, this disease has lifelong implications, both medically and socially.


Cite this as: BMJ 2012;345:e8192


  • Competing interests: None declared.