Journal of pediatric surgery · 2025
Bowel function and quality of life in adolescents with Hirschsprung Disease.
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Karlsen Remi Andre, Hoel Anders Telle, Karaji Negin, Sæter Thorstein, Stensrud Kjetil Juul, Bjørnland Kristin
Аннотация
BACKGROUND: Functional bowel problems are common in children following surgery for Hirschsprung Disease (HD), but there is limited information regarding bowel function and its potential impact on quality of life (QoL) in HD adolescents. Therefore, this study investigates bowel function and QoL within a national cohort of HD adolescents.
METHODS AND PATIENTS: This cross-sectional study invited all Norwegian HD adolescents, 12-18 years. Data were gathered from electronic patient records and through questionnaires; Bowel Function Score (BFS), PedsQL Gastrointestinal Symptoms Module (PedsQL-GSM), and PedsQL Generic Core Scale (PedsQL-GCS). QoL data from patients and controls were compared (PedsQL-GSM: 513 controls; PedsQL-GCS 425 controls).
RESULTS: 77/84 (92 %) adolescents, median 14.0 (12.0-18.4) years, participated. Fifty-nine (77 %) were boys, and eight (10 %) were syndromic/neurologically impaired. Rectosigmoid aganglionosis affected 60 (78 %). A pull-through procedure was performed on 73; 49 underwent endorectal pull-through, 12 the Swenson procedure, and 12 the Duhamel procedure. Nineteen (25 %) utilized regular enemas, and nine (12 %) had a stoma. Among those not using regular enemas or had a stoma, 30 (39 %) reported BFS Score ≥17. Total PedsQL-GSM score was significantly lower compared to controls (83.2 vs. 88.6, p < 0.01). "Stomach pain" and "gas and bloating" were most common symptoms. Patients reported generic QoL comparable to controls. Gastrointestinal symptoms correlated with reduced generic QoL.
CONCLUSION: Persistent functional bowel problems are common among HD adolescents, yet their generic QoL remains satisfactory. Given that bowel issues are associated with lower generic QoL, effective management of bowel problems appears essential for maintaining overall good QoL.
METHODS AND PATIENTS: This cross-sectional study invited all Norwegian HD adolescents, 12-18 years. Data were gathered from electronic patient records and through questionnaires; Bowel Function Score (BFS), PedsQL Gastrointestinal Symptoms Module (PedsQL-GSM), and PedsQL Generic Core Scale (PedsQL-GCS). QoL data from patients and controls were compared (PedsQL-GSM: 513 controls; PedsQL-GCS 425 controls).
RESULTS: 77/84 (92 %) adolescents, median 14.0 (12.0-18.4) years, participated. Fifty-nine (77 %) were boys, and eight (10 %) were syndromic/neurologically impaired. Rectosigmoid aganglionosis affected 60 (78 %). A pull-through procedure was performed on 73; 49 underwent endorectal pull-through, 12 the Swenson procedure, and 12 the Duhamel procedure. Nineteen (25 %) utilized regular enemas, and nine (12 %) had a stoma. Among those not using regular enemas or had a stoma, 30 (39 %) reported BFS Score ≥17. Total PedsQL-GSM score was significantly lower compared to controls (83.2 vs. 88.6, p < 0.01). "Stomach pain" and "gas and bloating" were most common symptoms. Patients reported generic QoL comparable to controls. Gastrointestinal symptoms correlated with reduced generic QoL.
CONCLUSION: Persistent functional bowel problems are common among HD adolescents, yet their generic QoL remains satisfactory. Given that bowel issues are associated with lower generic QoL, effective management of bowel problems appears essential for maintaining overall good QoL.