After pull-through surgery for Hirschsprung's disease, some patients develop faecal incontinence despite an anatomically intact anal canal. When this coincides with a dilated colon and constipation driven by colonic hypomotility, medical management is the first-line approach.
Post-pull-through patient with faecal incontinence, intact anal canal, and a dilated colon with constipation (colonic hypomotility). Patients with an intact anal canal and appropriate pull-through but faecal incontinence should receive medical management as the first-line treatment.
First-line management centres on oral laxatives aimed at achieving regular and complete colonic emptying. Further adjunctive measures may be considered where required.
DOI: 10.1186/s13023-020-01362-3
Patients with an intact anal canal and appropriate pull-through but fecal incontinence should receive medical management as the first-line treatment.
For patients with a dilated colon and constipation (hypomotility), oral laxatives +/− a short course of enemas to ensure regular and complete colonic emptying.
In patients with an intact dentate line and good sphincter function without outlet obstruction but colonic hypomotility, first line management comprises oral laxatives, supplemented with a short course of enemas if required.
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