{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:10:11Z","timestamp":1792782611805,"version":"4.5.0"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:00:00Z","timestamp":1790380800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:00:00Z","timestamp":1790380800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100012558","name":"Sk\u00e5ne County Council's Research and Development Foundation","doi-asserted-by":"publisher","award":["43980"],"award-info":[{"award-number":["43980"]}],"id":[{"id":"10.13039\/100012558","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Sk\u00e5ne University Hospital Funding","award":["95908"],"award-info":[{"award-number":["95908"]}],"id":[{"id":"https:\/\/ror.org\/02z31g829","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Surg Int"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Growth and diet are major concerns for patients with Hirschsprung\u2019s disease yet are rarely described. This study aimed to investigate self-reported growth and the dietary impact on gastrointestinal symptoms in children with Hirschsprung\u2019s disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This observational cross-sectional study used a validated self-report questionnaire. All children aged 1\u201318 years old (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200985) with Hirschsprung\u2019s disease treated at a national center were invited to participate.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 71 children (84%) participated (median age 6 years [range 1\u201317]). Stunting was reported in 6 of 71 children (9%), with no significant difference between those with rectosigmoid and long-segment aganglionosis (4\/58 [7%] vs. 2\/13 [15%],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.328). The majority (55\/71; 77%) reported diet-induced gastrointestinal symptoms, again with no significant difference between the groups (43\/58 [74%] vs. 12\/13 [92%]\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.227). Of the 90 food items assessed, the most frequently reported to trigger symptoms were high in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs), free sugar and fat.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Diet-related gastrointestinal complaints are reported frequently in children with Hirschsprung\u2019s disease, regardless of aganglionic extent. The findings highlight the need to assess growth and dietary factors in follow-up care and support further interventional studies on dietary strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00383-026-06657-3","type":"journal-article","created":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T08:56:31Z","timestamp":1790412991000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Growth and dietary effects on gastrointestinal symptoms in children with Hirschsprung\u2019s disease"],"prefix":"10.1007","volume":"42","author":[{"given":"Lovisa","family":"Telborn","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Axelsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Gran\u00e9li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pernilla","family":"Stenstr\u00f6m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,26]]},"reference":[{"key":"6657_CR1","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1002\/jpn3.70442","volume":"83","author":"D Rossi","year":"2026","unstructured":"Rossi D, Irvine W, Granstrom AL et al (2026) Updated ERNICA guidelines for the management of rectosigmoid Hirschsprung\u2019s disease 2025. J Pediatr Gastroenterol Nutr 83:185\u2013207. https:\/\/doi.org\/10.1002\/jpn3.70442","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"6657_CR2","doi-asserted-by":"publisher","first-page":"1418","DOI":"10.3390\/children10081418","volume":"10","author":"E Bokova","year":"2023","unstructured":"Bokova E, Prasade N, Janumpally S et al (2023) State of the art bowel management for pediatric colorectal problems: Hirschsprung\u2019s disease. Children 10:1418. https:\/\/doi.org\/10.3390\/children10081418","journal-title":"Children"},{"key":"6657_CR3","doi-asserted-by":"publisher","first-page":"1502","DOI":"10.1016\/j.jpedsurg.2021.01.043","volume":"56","author":"J Davidson","year":"2021","unstructured":"Davidson J, Kyrklund K, Eaton S et al (2021) Long-term surgical and patient-reported outcomes of Hirschsprung\u2019s disease. J Pediatr Surg 56:1502\u20131511. https:\/\/doi.org\/10.1016\/j.jpedsurg.2021.01.043","journal-title":"J Pediatr Surg"},{"key":"6657_CR4","doi-asserted-by":"publisher","first-page":"1458","DOI":"10.1016\/j.jpedsurg.2017.01.001","volume":"52","author":"K Bjornland","year":"2017","unstructured":"Bjornland K, Pakarinen MP, Stenstr\u00f6m P et al (2017) A Nordic multicenter survey of long-term bowel function after transanal endorectal pull-through in 200 patients with rectosigmoid Hirschsprung\u2019s\u2019s disease. J Pediatr Surg 52:1458\u20131464. https:\/\/doi.org\/10.1016\/j.jpedsurg.2017.01.001","journal-title":"J Pediatr Surg"},{"key":"6657_CR5","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1097\/MPG.0000000000003717","volume":"76","author":"L Ambartsumyan","year":"2023","unstructured":"Ambartsumyan L, Patel D, Kapavarapu P et al (2023) Evaluation and management of postsurgical patient with Hirschsprung\u2019s disease neurogastroenteology & motility committee: position paper of North American society of pediatric gastroenterology, hepatology and nutrition (NASPGHAN). J Pediatr Gastroenterol Nutr 76:533\u2013546. https:\/\/doi.org\/10.1097\/MPG.0000000000003717","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"6657_CR6","doi-asserted-by":"publisher","first-page":"1302","DOI":"10.1016\/j.jpedsurg.2016.11.033","volume":"52","author":"P Stenstr\u00f6m","year":"2017","unstructured":"Stenstr\u00f6m P, Brautigam M, Borg H, Gran\u00e9li C, Llja HE, Wester T (2017) Patient-reported Swedish nationwide outcomes for children and adolescents with total colonic aganglionosis. J Pediatr Surg 52:1302\u20131307. https:\/\/doi.org\/10.1016\/j.jpedsurg.2016.11.033","journal-title":"J Pediatr Surg"},{"key":"6657_CR7","doi-asserted-by":"publisher","first-page":"943","DOI":"10.1002\/bjs5.50317","volume":"4","author":"P Stenstr\u00f6m","year":"2020","unstructured":"Stenstr\u00f6m P, Kyrklund K, Br\u00e4utigam M, Engstrand Lilja H, Juul Stensrud K, L\u00f6f Granstr\u00f6m A et al (2020) Total colonic aganglionosis: multicentre study of surgical treatment and patient-reported outcomes up to adulthood. Br J Surg Open 4:943\u2013953. https:\/\/doi.org\/10.1002\/bjs5.50317","journal-title":"Br J Surg Open"},{"issue":"10","key":"6657_CR8","doi-asserted-by":"publisher","first-page":"161565","DOI":"10.1016\/j.jpedsurg.2024.04.019","volume":"59","author":"AL Granstr\u00f6m","year":"2024","unstructured":"Granstr\u00f6m AL, Irvine W, Hoel AT et al (2024) ERNICA clinical consensus statements on total colonic and intestinal aganglionosis. J Pediatr Surg 59(10):161565. https:\/\/doi.org\/10.1016\/j.jpedsurg.2024.04.019","journal-title":"J Pediatr Surg"},{"key":"6657_CR9","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1016\/j.jpeds.2014.02.062","volume":"165","author":"K More","year":"2014","unstructured":"More K, Rao S, McMichael J, Minutillo C (2014) Growth and developmental outcomes of infants with Hirschsprung\u2019s\u2019s disease presenting in the neonatal period: a retrospective study. J Pediatr 165:73\u201377. https:\/\/doi.org\/10.1016\/j.jpeds.2014.02.062","journal-title":"J Pediatr"},{"key":"6657_CR10","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/S0022-3468(97)90085-3","volume":"32","author":"H Ikawa","year":"1997","unstructured":"Ikawa H, Masuyma H, Hirabayashi T, Endo M, Yokoyama J (1997) More than 10 years\u2019 follow-up to total colonic aganglionosis \u2013 severe iron deficiency anemia and growth retardation. J Pediatr Surg 32:25\u201327. https:\/\/doi.org\/10.1016\/S0022-3468(97)90085-3","journal-title":"J Pediatr Surg"},{"key":"6657_CR11","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1186\/s12893-018-0383-6","volume":"18","author":"C Urla","year":"2018","unstructured":"Urla C, Lieber J, Obermayr F et al (2018) Surgical treatment of children with total colonic aganglionosis: functional and metabolic long-term outcome. BMC Surg 18:58. https:\/\/doi.org\/10.1186\/s12893-018-0383-6","journal-title":"BMC Surg"},{"key":"6657_CR12","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1111\/codi.14095","volume":"20","author":"D Roorda","year":"2018","unstructured":"Roorda D, Witvliet MJ, Wellens LM et al (2018) Long-term outcome and quality of life in patients with total colonic aganglionosis in the Netherlands. Colorectal Dis 20:719\u2013726. https:\/\/doi.org\/10.1111\/codi.14095","journal-title":"Colorectal Dis"},{"key":"6657_CR13","doi-asserted-by":"publisher","first-page":"e297","DOI":"10.2196\/jmir.9701","volume":"20","author":"KD Wittmeier","year":"2018","unstructured":"Wittmeier KD, Hobbs-Muriosn K, Holland C, Crawford E, Loewen H, Morris M et al (2018) Identifying information needs for Hirschsprung\u2019s\u2019s disease through caregiver involvement via social media: a prioritization study and literature review. J Med Internet Res 20:e297. https:\/\/doi.org\/10.2196\/jmir.9701","journal-title":"J Med Internet Res"},{"issue":"9","key":"6657_CR14","doi-asserted-by":"publisher","first-page":"2620","DOI":"10.1111\/apa.15952","volume":"110","author":"L Telborn","year":"2021","unstructured":"Telborn L, Tofft L, Hallstr\u00f6m I, Axelsson I, Brandstr\u00f6m F, Stenstr\u00f6m P (2021) Diet plays a central role in parent\u2019s self-treatment of children with Hirschsprung\u2019s\u2019s disease \u2013 a focus group study. Acta Paediatr 110(9):2620\u20132617. https:\/\/doi.org\/10.1111\/apa.15952","journal-title":"Acta Paediatr"},{"key":"6657_CR15","doi-asserted-by":"publisher","first-page":"1543","DOI":"10.3390\/children10091543","volume":"10","author":"L Telborn","year":"2023","unstructured":"Telborn L, Gran\u00e9li C, Axelsson I, Stenstr\u00f6m P (2023) Children with Hirschsprung\u2019s\u2019s disease report dietary effects on gastrointestinal complaints more frequently than controls. Children 10:1543. https:\/\/doi.org\/10.3390\/children10091543","journal-title":"Children"},{"key":"6657_CR16","doi-asserted-by":"publisher","first-page":"1118","DOI":"10.3390\/children11091118","volume":"11","author":"J Lindert","year":"2024","unstructured":"Lindert J, Day H, de Andres Crespo M, Amerstorfer E, Alexander S, Backes M, de Filippo C, Golebiewski A, Midrio P, Mohideen M et al (2024) Influence of diet on bowel function and abdominal symptoms in children and adolescents with Hirschsprung\u2019s disease \u2013 a multinational patient-reported outcome survey. Children 11:1118. https:\/\/doi.org\/10.3390\/children11091118","journal-title":"Children"},{"key":"6657_CR17","doi-asserted-by":"publisher","first-page":"e103","DOI":"10.1097\/MPG.0000000000003411","volume":"74","author":"C Berrios","year":"2022","unstructured":"Berrios C, Bollinger J, Yan J, Bisecker B, Cakravarti A (2022) Identifying needs, challenges and benefits among adults and parents of children with Hirschsprung\u2019s disease. J Pediatr Gastroenterol Nutr 74:e103\u2013e108. https:\/\/doi.org\/10.1097\/MPG.0000000000003411","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"6657_CR18","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1186\/s40795-023-00737-6","volume":"9","author":"L Telborn","year":"2023","unstructured":"Telborn L, Kumlien C, Gran\u00e9li C, Axelsson I, Stenstr\u00f6m P (2023) Diet and bowel function in children with Hirschsprung\u2019s\u2019s disease: development and content validation of a patient-reported questionnaire. BMC Nutr 9:78. https:\/\/doi.org\/10.1186\/s40795-023-00737-6","journal-title":"BMC Nutr"},{"key":"6657_CR19","unstructured":"World Health Organization https:\/\/www.who.int\/toolkits\/child-growth-standards\/standards\/body-mass-index-for-age-bmi-for-age Accessed 15 September 2026"},{"key":"6657_CR20","unstructured":"World Health Organization https:\/\/www.who.int\/tools\/growth-reference-data-for-5to19-years\/indicators\/bmi-for-age Accessed 15 September 2026"},{"key":"6657_CR21","unstructured":"World Health Organization https:\/\/www.who.int\/tools\/child-growth-standards\/standards\/length-height-for-age Accessed 15 September 2026"},{"key":"6657_CR22","unstructured":"World Health Organization https:\/\/www.who.int\/tools\/growth-reference-data-for-5to19-years\/indicators\/height-for-age Accessed 15 September 2026"},{"key":"6657_CR23","unstructured":"World Health Organization https:\/\/www.who.int\/tools\/child-growth-standards\/standards\/weight-for-length-height Accessed 15 September 2026"},{"key":"6657_CR24","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1016\/0022-3468(95)90064-0","volume":"30","author":"RJ Rintala","year":"1995","unstructured":"Rintala RJ, Lindahl H (1995) Is normal bowel function possible after repair of intermediate and high anorectal malformations? J Pediatr Surg 30:491\u2013494. https:\/\/doi.org\/10.1016\/0022-3468(95)90064-0","journal-title":"J Pediatr Surg"},{"key":"6657_CR25","doi-asserted-by":"publisher","first-page":"823","DOI":"10.1016\/S0022-3468(97)90628-X","volume":"32","author":"RJ Rintala","year":"1997","unstructured":"Rintala RJ, Lindahl HG, Rasanen M (1997) Do children with repaired low anorectal malformations have normal bowel function? J Pediatr Surg 32:823\u2013826. https:\/\/doi.org\/10.1016\/S0022-3468(97)90628-X","journal-title":"J Pediatr Surg"},{"key":"6657_CR26","unstructured":"https:\/\/www.rikshandboken-bhv.se\/halsobesok\/halsoundersokning\/tillvaxt\/avvikande-langdtillvaxt\/#section-31828 Accessed 15 September 2025"},{"key":"6657_CR27","doi-asserted-by":"publisher","first-page":"2273","DOI":"10.1111\/j.1440-1746.2006.04750.x","volume":"22","author":"AG Catto-Smith","year":"2007","unstructured":"Catto-Smith AG, Trajanovska M, Taylor RG (2007) Long-term continence after surgery for Hirschsprung\u2019s\u2019s disease. J Gastroenterol Hepatol 22:2273\u20132282. https:\/\/doi.org\/10.1111\/j.1440-1746.2006.04750.x","journal-title":"J Gastroenterol Hepatol"},{"key":"6657_CR28","doi-asserted-by":"publisher","first-page":"954","DOI":"10.1016\/s0022-3476(95)70036-6","volume":"127","author":"AG Catto-Smith","year":"1995","unstructured":"Catto-Smith AG, Coffey CM, Nolan TM et al (1995) Fecal incontinence after the surgical treatment of Hirschsprung\u2019s disease. J Pediatr 127:954\u2013957. https:\/\/doi.org\/10.1016\/s0022-3476(95)70036-6","journal-title":"J Pediatr"},{"key":"6657_CR29","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1007\/s00383-026-06605-1","volume":"42","author":"C Scaramella","year":"2026","unstructured":"Scaramella C, Telborn L, Davidson J et al (2026) Gastrointestinal symptoms and association to food items in children with Hirschsrpung disease: a multinational patient-reported outcome study from Latin America and Spain. Pediatr Surg Int 42:380. https:\/\/doi.org\/10.1007\/s00383-026-06605-1","journal-title":"Pediatr Surg Int"},{"key":"6657_CR30","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1097\/MPG.0000000000003526","volume":"75","author":"RA Thomassen","year":"2022","unstructured":"Thomassen RA, Luque V, Assa A et al (2022) An ESPGHAN position paper on the use of low-FODMAP diet in pediatric gastroenterology. J Pediatr Gastroenterol Nutr 75:356\u2013368. https:\/\/doi.org\/10.1097\/MPG.0000000000003526","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"6657_CR31","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1007\/s1189f4-022-00849-2","volume":"24","author":"L Dorfman","year":"2022","unstructured":"Dorfman L, EL-Chammas K, Mansi S et al (2022) Gastrocolonic Response. Curr Gastroenterol Rep 24:137\u2013144. https:\/\/doi.org\/10.1007\/s1189f4-022-00849-2","journal-title":"Curr Gastroenterol Rep"},{"key":"6657_CR32","doi-asserted-by":"publisher","first-page":"773","DOI":"10.1007\/s00383-016-3919-9","volume":"32","author":"L Stathopoulos","year":"2016","unstructured":"Stathopoulos L, King Sm Southwell B et al (2016) Nuclear transit study in children with chronic faecal soiling after Hirschsprung\u2019s disease (HSCR) surgery has revealed a group with rapid proximal colonic treatment and possible adverse reactions to food. Pediatr Surg Int 32:773\u2013777. https:\/\/doi.org\/10.1007\/s00383-016-3919-9","journal-title":"Pediatr Surg Int"},{"key":"6657_CR33","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1097\/MPG.0b013e3181efe551","volume":"52","author":"A Kaul","year":"2011","unstructured":"Kaul A, Garza JM, Connor FL et al (2011) Colonic hyperactivity results in frequent fecal soiling in a subset of children after surgery for Hirschsprung disease. J Pediatr Gastroenterol Nutr 52:433\u2013436. https:\/\/doi.org\/10.1097\/MPG.0b013e3181efe551","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"6657_CR34","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1007\/s00383-017-4066-7","volume":"33","author":"JC Langer","year":"2017","unstructured":"Langer JC, Rollins MD, Levitt M et al (2017) Guidelines for the management of postoperative obstructive symptoms in children with Hirschsprung\u2019s disease. Pediatr Surg Int 33:523\u2013526","journal-title":"Pediatr Surg Int"},{"issue":"6","key":"6657_CR35","doi-asserted-by":"publisher","first-page":"1456","DOI":"10.1053\/j.gastro.2016.02.015","volume":"150","author":"JS Hyams","year":"2016","unstructured":"Hyams JS, DiLorenzo C, Saps M et al (2016) Childhood functional gastrointestinal disorders: Child\/adolescent. Gastroenterol 150(6):1456\u20131468","journal-title":"Gastroenterol"}],"container-title":["Pediatric Surgery International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00383-026-06657-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00383-026-06657-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00383-026-06657-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T21:02:35Z","timestamp":1790456555000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00383-026-06657-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,26]]},"references-count":35,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["6657"],"URL":"https:\/\/doi.org\/10.1007\/s00383-026-06657-3","relation":{},"ISSN":["1437-9813"],"issn-type":[{"value":"1437-9813","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,26]]},"assertion":[{"value":"20 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 September 2026","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors have no competing interests to declare that are relevant to the content of this article.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The research involved Human Participants. The study was conducted in accordance with the Declaration of Helsinki and was approved by the Swedish Ethical Review Authority (registration number 2018\/720).","order":2,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Participants received age-appropriate oral and written information. Informed consent was obtained from both legal guardians for children under 15 years of age, while adolescents aged 15 years or older provided their own consent.","order":3,"name":"Ethics","label":"Consent","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Reporting guidelines for observational studies (STROBE) were followed.","order":4,"name":"Ethics","label":"Standards of reporting","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"425"}}