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Suggest Treatment For Anorectal Malformation In A Down Syndrome Child
Question: My grandson was born with Downs syndrome and no anus. He has had the operation to correct this. This past week at 17 months, his mother weaned him. He has not had a bowel movement for a week although he is given senokot (2 per day). What should his mother do?
Brief Answer:
The problem lies in the nerve supply of the bowels
Detailed Answer:
Hello,
I am sorry that your grandson was born with Down syndrome. There are various complications that such a baby has. You have mentioned that the baby had an anorectal malformation in the form of imperforate anus which has been operated upon. Often there is an entity called Hirschsprung's disease associated along with where there is a problem with the development of the nerve cells (ganglion cells) that innervate the walls of the large bowels that cause the bowel movements. Although the muscular structures have been restructured, it is not possible for us to redesign the nerve supply which should be responsible for a smooth bowel movement. Since that is not present, he is not having regular bowel movements and even natural bulk forming vegetable laxatives like Senokot are not becoming effective.
A glycerine suppository or a P-enema could help him in passing the stool once but cannot help in regularizing it.Discuss about this your doctor. There is not that the mother can do other than to give him support symptom-wise.
Let me remark that this is not the only problem that he would be facing. There is much that you need to be prepared for. A proper support system can however give him a stable life to adulthood. Wish you all the best for being concerned.
Hope that I have been able to solve the query. Feel free to revert back in case of further queries. In case you are satisfied with the answer that I have provided, please leave a positive response.
The problem lies in the nerve supply of the bowels
Detailed Answer:
Hello,
I am sorry that your grandson was born with Down syndrome. There are various complications that such a baby has. You have mentioned that the baby had an anorectal malformation in the form of imperforate anus which has been operated upon. Often there is an entity called Hirschsprung's disease associated along with where there is a problem with the development of the nerve cells (ganglion cells) that innervate the walls of the large bowels that cause the bowel movements. Although the muscular structures have been restructured, it is not possible for us to redesign the nerve supply which should be responsible for a smooth bowel movement. Since that is not present, he is not having regular bowel movements and even natural bulk forming vegetable laxatives like Senokot are not becoming effective.
A glycerine suppository or a P-enema could help him in passing the stool once but cannot help in regularizing it.Discuss about this your doctor. There is not that the mother can do other than to give him support symptom-wise.
Let me remark that this is not the only problem that he would be facing. There is much that you need to be prepared for. A proper support system can however give him a stable life to adulthood. Wish you all the best for being concerned.
Hope that I have been able to solve the query. Feel free to revert back in case of further queries. In case you are satisfied with the answer that I have provided, please leave a positive response.
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Answered by
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