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Hirschsprung’s-associated Enterocolitis

(HAEC)

Definition

Hirschsprung’s-associated enterocolitis (HAEC) is a complication of Hirschsprung’s disease . This is a rare condition that occurs in babies. It occurs when there are no nerve cells in the bowel. These nerve cells normally help control the bowel muscles that allow stool to move through the colon. The absence of these cells results in a bowel obstruction. This prevents normal bowel movements.
Enterocolitis is an inflammation or infection of the bowel. HAEC can happen suddenly and requires immediate care by a doctor. In most cases, hospital care is needed.
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Causes

HAEC occurs when the bowel becomes inflamed or infected. This may be caused by:

Risk Factors

Risk factors for HAEC include:

Symptoms

Symptoms may include:
These symptoms may be caused by other conditions. If your child has any of these symptoms, tell the doctor right away.

Diagnosis

You will be asked about your child’s symptoms and medical history. A physical exam will be done.
Your child's bodily fluids may be tested. This can be done with blood tests.
Abdominal x-rays may be used to evaluate the intestines or other nearby structures.
A child who has had pull-through surgery to treat an intestinal blockage will be closely monitored for symptoms of HAEC. While most cases of HAEC occur within 2 years after pull-through surgery, it can occur up to 10 years following surgery.
If the doctor suspects HAEC, barium enemas will be avoided. Barium enemas increases the risk of bowel perforation.

Treatment

Talk with the doctor about the best treatment plan for your child. Treatment options include:

Prevention

To help reduce your child’s chance of HAEC, rectal irrigation may be done after pull-through surgery to try to prevent HAEC.

RESOURCES

Healthy Children—American Academy of Pediatrics http://www.healthychildren.org

International Foundation for Functional Gastrointestinal Disorders http://www.iffgd.org

CANADIAN RESOURCES

Canadian Association of Gastroenterology https://www.cag-acg.org

Caring for Kids—Canadian Paediatric Society http://www.caringforkids.cps.ca

References

Hirschsprung’s Disease. International Foundation for Functional Gastrointestinal Disorders About Kids GI website. Available at: http://www.aboutkidsgi.org/site/lower-gi-disorders/hirschsprungs-disease. Updated October 28, 2014. Updated October 30, 2014.

Kessmann J. Hirschsprung’s disease: diagnosis and management. Am Fam Physician. 2006;74(8):1319-1322.

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