Advocating for Bridget: Coping with Hirschsprung ’s disease
On June 20, Bridget Landry celebrated a very special day with a hearty steak dinner. But it wasn’t her birthday. Instead, the 10-year-old and her family were marking the sixth anniversary of the day her ostomy bag was removed. As she enjoyed her meal, her parents, Carl and Laura, marveled at just how far their daughter had come. “For her first birthday, she couldn’t even take a bite of cake,” remembers Carl. Bridget’s first few months of life were similar to those of most infants: She had a typical birth, nursed and met all her milestones. Yet at six months, her parents began to notice something was amiss. She wouldn’t eat solid food, wasn’t having bowel movements and her belly looked distended. Her pediatrician suggested that she might just be constipated. “But in our heart of hearts, we knew something wasn’t right,” says Laura. A frustrating diagnosis By the time she was a year old, Bridget’s doctors in Maine had diagnosed her with Hirschsprung’s disease, a disorder in which some of the intestinal nerve cells don’t develop properly, causing them to interfere with the movement of food and stool in the intestines. Although the majority of children with Hirschsprung’s develop obstructions and other symptoms within the first six months of life, others don’t show signs of the disease for months or years. Her local surgeons treated her condition with a standard approach called a pull-throug...
An article was published in the Journal of Pediatric Surgery by Gasior et al., “Surgical management of the functional constipation: An intermediate report of a new approach using a laparoscopic sigmoid resection combined with a Malone appendicostomy” . Analysis of this article and previous works showed the following: The authors do not use modern research methods widely used by pediatricians and adult surgeons (anorectal manometry and defecography). They “…believe that the diagnosis of idiopathic constipation is a clinical one” .
We would like to thank Dr. Levin for his ongoing interest in our work and the letter he wrote concerning our group's publication titled “Surgical management of functional constipation: an intermediate report of a new approach using a laparoscopic sigmoid resection combined with malone appendicostomy.”
Authors: Black CJ, Ford AC Abstract Chronic idiopathic constipation (CIC) is one of the most common gastrointestinal disorders, with a global prevalence of 14%. It is commoner in women and its prevalence increases with age. There are three subtypes of CIC: dyssynergic defaecation, slow transit constipation and normal transit constipation, which is the most common subtype. Clinical assessment of the patient with constipation requires careful history taking, in order to identify any red flag symptoms that would necessitate further investigation with colonoscopy to exclude colorectal malignancy. Screening for hypercal...
CONCLUSION: LPL rectopexy is a safe, effective method showing good functional outcomes by providing firm, solid fixation for patients with a full-thickness rectal prolapse. PMID: 29991200 [PubMed]
Conclusion: The crude extracts and fractions exhibited excellent activity due to active phytochemicals. These active phytochemicals also exhibited promising interaction with COX-1 and COX-2. These findings directed researcher to isolate active compounds from H. radicata which may be used as a potential source of active secondary metabolites. PMID: 29992141 [PubMed - in process]
Traveler ’ s constipation is probably real. And the scientific evidence behind it is fascinating.
Conclusions: The data confirmed the validity of addressing OAB before treating enuresis. The results of this study also highlight the need to address fecal impaction. Patients should be counseled about the need for a prolonged course of treatment before starting treatment. Anticholinergics should be accompanied with either desmopressin or laxatives for better control of enuresis. PMID: 29991232 [PubMed]
Abstract Somatostatin analogues (SSA) are a common treatment for some forms of neuroendocrine tumours (NETs). Patients report a variety of side effects after starting these drugs, so in most cases they require a lot of nutritional input. The authors used an online survey to invite responses from patients worldwide to determine the extent of reported side effects. Patients were asked which SSA they were taking and how they rated the severity of their side effects. They were provided with a list of 11 options to choose from, but not given any guidance or a definition of terms. The most commonly reported side effect ...
CONCLUSION: The discharge diagnoses covered a wide range. A systematic approach to pain evaluation could help to ensure that the diagnostic process is both thorough and efficient. Common childhood ailments such as constipation or urinary tract infection, as well as other causes, must be considered when diagnosing pain in this population. Practice implications include consulting parents regarding changes in a child's behavior. PMID: 30004904 [PubMed - as supplied by publisher]
Despite using opioids for centuries for pain management, we still don ’t have a complete understanding of how drugs like morphine and oxycodone actually work. And that’s a problem for patients, who must weather side effects that can range from nausea and constipation to cognitive impairment, addiction, and, at high doses, even death.