Hirschsprung's disease is the most common congenital malformation of the enteric nervous system with an incidence of approximately 1 in 5000 live births.24-26 Whilst most cases are sporadic a positive familial occurrence exists in 3.6-7.8% of cases27 and the presence of co-existing abnormalities including trisomy 21 suggests a genetic involvement (see also Chapter 17).
This condition is characterized by the absence of enteric neurons and hypertrophy of nerve trunks in the distal bowel always involving the rectum and for a variable distance proximally. There is an absence of peristaltic activity in this aganglionic segment resulting in symptoms of intractable constipation. The bowel proximal to the agan-glionic segment contains ganglionated cells, and peristaltic activity is normal. However, in the so-called transitional zone, immediately proximal to the aganglionic segment, neuronal cells may exist but they are commonly of abnormal architecture and the intestinal peristalsis is abnormal. This zone is of fundamental importance when considering surgical treatment of this disorder.
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Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.