{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T08:43:00Z","timestamp":1789980180565,"version":"4.0.1"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2011,7,1]],"date-time":"2011-07-01T00:00:00Z","timestamp":1309478400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K24\u2010DK082792A"],"award-info":[{"award-number":["K24\u2010DK082792A"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2011,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and Objective:<\/jats:title><jats:p>The majority of children with Hirschsprung disease (HD) after corrective surgery (CS) develop protracted defecation disorders (DDs) such as constipation, fecal incontinence, and\/or enterocolitis. The aim of this investigation was to determine the diagnoses, therapies, and long\u2010term clinical outcomes using a systematic algorithm to address protracted DD in children with HD after CS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p>Retrospective review of children with HD after CS cared for using a systematic algorithm at a tertiary care center. Potential anatomic etiologies were evaluated for first. Clinical outcome was categorized into 4 groups based on symptom severity, time interval from last enterocolitis episode, laxative usage, and\/or rectal therapies at the time of last follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>Fifty\u2010seven children were identified, of whom 51 (89.5%) had obstructive symptoms and\/or enterocolitis and 6 (10.5%) had nonretentive fecal incontinence. Nonintractable constipation responsive to laxatives was identified in 10 (17.5%), colonic dysmotility in 4 (7.0%), nonrelaxing anal sphincter as a primary etiology in 22 (38.6%), bacterial overgrowth in 2 (3.5%), food intolerance in 2 (3.5%), and rapid transit in 2 (3.5%). Further surgical intervention was undertaken in 22 (38.6%), including 9 (15.8%) for residual aganglionosis. Mean follow\u2010up was 41.4 \u00b1 4.5 months. Clinical outcomes were excellent in 16 (28.1%), good in 22 (38.6%), fair in 1 (1.8%), and poor in 18 (31.6%). Children with enterocolitis were more likely to have an excellent or good clinical outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>The majority of children with HD and protracted DD after CS have a favorable long\u2010term clinical outcome when following a systematic algorithm.<\/jats:p><\/jats:sec>","DOI":"10.1097\/mpg.0b013e318212eb53","type":"journal-article","created":{"date-parts":[[2011,6,21]],"date-time":"2011-06-21T02:48:18Z","timestamp":1308624498000},"page":"75-79","source":"Crossref","is-referenced-by-count":76,"title":["Defecation Disorders in Children After Surgery for Hirschsprung Disease"],"prefix":"10.1002","volume":"53","author":[{"given":"Bruno P","family":"Chumpitazi","sequence":"first","affiliation":[{"name":"Center for Motility and Functional Gastrointestinal Disorders Children's Hospital Boston Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Nurko","sequence":"additional","affiliation":[{"name":"Center for Motility and Functional Gastrointestinal Disorders Children's Hospital Boston Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,7]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.1085649"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200006013422207"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1994.tb12955.x"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.sempedsurg.2004.10.013"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(95)70036-6"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.scs.0000180310.47793.91"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-006-1783-8"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1536-4801.2003.tb12000.x"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-006-1639-2"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2006-924729"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(99)90588-2"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2007.12.038"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mpg.0000304448.69305.28"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-002-0897-x"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2008.10.053"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2008.110"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1996.01430170066013"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(99)90247-6"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2006.10.058"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2004.06.008"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2008.03.035"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2000.02183.x"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2003.07412.x"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1053\/jpsu.2000.19234"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(96)90149-9"},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(97)90557-1"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.MPG.0000151760.43664.FB"}],"container-title":["Journal of Pediatric Gastroenterology and Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1097\/MPG.0b013e318212eb53","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T09:07:52Z","timestamp":1705568872000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1097\/MPG.0b013e318212eb53"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,7]]},"references-count":27,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2011,7]]}},"alternative-id":["10.1097\/MPG.0b013e318212eb53"],"URL":"https:\/\/doi.org\/10.1097\/mpg.0b013e318212eb53","archive":["Portico"],"relation":{},"ISSN":["0277-2116","1536-4801"],"issn-type":[{"value":"0277-2116","type":"print"},{"value":"1536-4801","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,7]]}}}