Naked Science Forum
Life Sciences => Physiology & Medicine => Topic started by: Broca on 28/08/2003 16:23:28
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My friends son has Hirschsprungs and has only enough of his intestines left to make one attepmt at reconnection. He is 8 years old and the decision to take the chance of reconnectiong the colon to his anus has been a very difficult one. The surgeries and recovery are very arduous at best with no promise of success. I was wondering if anyone had any information on the outlook or viability of cloning a colon.
Thank you,
Broca
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DonT know all the ins and outs, but stem cell research sounds quite miraculous. Could this be postponed by going with a colostomy for a while until they're sure of what action to take?
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The child has had a colostomy for his entire life. I am rather hopeful at the new discoveries being made in stem cells as well. The child is not in any medical danger at this time, it is an inconvenience for him and as we all know children do not like being different. I am only trying to get as much information as I can so that when doctor visits are made, and decisions have to be made, they can be done with an informed mind.
I also wonder if the hirschsprungs can become viable in the small amount of of intestine he has left, making the choices even more immediate.
Knowledge is power! <smile>
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I'm sure Chris and Bezoar are going to be the best source for info on this. I'm a big dolt when it comes to medicine. If it doesn't take a bandaid, I'm clueless. My heart goes out to this little boy. I'm sure he's fed up with this. I'll be praying for him.
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Thank you for your thoughts and prayers. He is a great kid and as long as he remains healthy he is still a very lucky young man.I am thrilled that you replied to my posting! Thanks!
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Hirschsprung's disease, as I recall, is the same as congenital aganglionic megacolon, meaning there is a congenital lack of ganglion or nerve cells in part of the colon. After appropriate testing, the treatment of choice is generally what happened to this boy. A colostomy is done, and then eventually they get reconnected. Exactly what area of the colon needs to be removed can be determined by tests. The part they left in would be the normal part, and no, it shouldn't develop the disease later on. My understanding is that what you're born with, or without as the case may be, is what the extent of the disease is.
Being as I'm only a nurse here, my question is one I need a surgeon to answer. If there is that little of the colon left, what happens as the kid grows taller? Will the colon be able to stretch adequately? If they say yes, then I'd go for it. The worst that can happen is that it fails, and they revert back to the colostomy. At age 8. let the child have a say in the decision. My guess is that he would go for it. And at 8, he'll be old enough to understand what he's getting into.
Bezoar
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The process of reattachment is tough enough, but from what i understand as well is that getting the sphincter muscle back in shape will keep the child out of school for a couple of years and the mother will have to either stay home or hire a nurse full time. The colonis acids are also very harmful to the skin so apparently there is also a high incidence of open, sore wounds on the little guys bum! I had not thought of the growth aspect, thank you for that insight. Thank you for all of it really.Keep it coming! :-)
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Hydrous Lanolin is one of the best barriers to acid irritation to skin that I know of. When my girls were in diapers, it could cure a diaper rash in a matter of hours. Maybe Chris can answer. What's the problem with sphincter tone? And what type of training does it involve that should keep him out of school? Some type of retraining involved? Seems to me, it would all be worth it if he could get a more normal life out of it. Not that colostomies are all that big a deal to someone who already has a life partner, but this poor boy, who will have to dress out in a locker room and date when he's older, that will inevitably be embarrassing for him.
Bezoar
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From what I understand, since the sphincter muscle has not been used, it will have to be built up in strength like any muscle. Until it is built up, the lack of control will create unpreventable accidents. He will be in a diaper until it is under control. I know that some things seem fairly simple to us, I would like to think that I would be able to keep my child clean enough that there would not be any horrid sores, but there is one other child in our town that has had the reversal, and he has suffered a great deal from these sores. My friend is very worried about that. She talks with the Mother and sees the long road that family has gone through and it has been two years for them and still that child is in diapers. We do not know if that is the norm or not. It is hard to find places to draw information from.
I also agree, that he would lead a more normal life, so it is worth the risk. I am glad however that I am not in a position where I have to make the decision. I was given the understanding that if the reconnection fails there might be other complications when re-attaching to the colostomy.
Thank you so much for your help, don't stop! :-)