Long-term bowel function and quality of life in children with Hirschsprung's disease.
OBJECTIVE
Little is known about the quality of life (QOL) of children with Hirschsprung's disease (HD) as they grow older. The purpose of this study was to measure the QOL and bowel function of these children as they mature.


METHODS
All children who were surgically treated for HD at British Columbia Children's Hospital, Vancouver, British Columbia, Canada between 1986 and 2003 were invited to participate. Each family was sent 3 previously validated questionnaires exploring current QOL and bowel function.


RESULTS
Fifty-one families participated (49%), with children between the ages of 3 and 21 years. Fecal continence improved significantly with age (P = .04) and was the strongest predictor of QOL scores of all variables in our study. There was no statistically significant difference in QOL scores between children with HD and healthy children, although a clinically relevant impairment in QOL may be present, especially in psychosocial scores.


CONCLUSIONS
Fecal continence is an important predictor of overall QOL in children surgically treated for HD. Although continence tends to improve with age, a number of older children still have ongoing continence problems, and they seem to be a group at risk for impaired QOL. Our study indicates that interventions for children with incontinence may offer gains in QOL as well as bowel function.
Mills
Jessica L A
JL
Division of Pediatric General Surgery, British Columbia Children's Hospital and the University of British Columbia, Vancouver, British Columbia, Canada V6M 2L8.
Konkin
David E
DE
Milner
Ruth
R
Penner
Janice G
JG
Langer
Monica
M
Webber
Eric M
EM
D000015:Abnormalities, Multiple / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003248:Constipation / Q000453:epidemiology / Q000503:physiopathology*; D005242:Fecal Incontinence / Q000145:classification / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006627:Hirschsprung Disease / Q000453:epidemiology / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D008297:Male; D011184:Postoperative Period; D011788:Quality of Life; D012720:Severity of Illness Index; D017678:Sex Distribution; D011795:Surveys and Questionnaires