{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T19:52:43Z","timestamp":1790452363098,"version":"4.1.0"},"reference-count":31,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T00:00:00Z","timestamp":1726099200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Deutsche Forschungsgemeinschaft (DFG)","award":["525829860"],"award-info":[{"award-number":["525829860"]}]},{"name":"Deutsche Forschungsgemeinschaft (DFG)","award":["463001064"],"award-info":[{"award-number":["463001064"]}]},{"name":"European Joint Programme Rare Disease","award":["525829860"],"award-info":[{"award-number":["525829860"]}]},{"name":"European Joint Programme Rare Disease","award":["463001064"],"award-info":[{"award-number":["463001064"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Introduction: This study aimed to understand the influence of diet and nutrition items on gastrointestinal symptoms in patients with Hirschsprung Disease (HD). Method: An online questionnaire was created to obtain patient-reported outcomes using the multinational Holistic Care in Hirschsprung Disease Network. This was distributed in Dutch, English, German, Italian, Polish, and Swedish via patient associations. Information on demographics, the extension of disease, current diet, and the influence of food ingredients on bowel function were obtained. Results: In total, 563 questionnaires were answered by parents or patients themselves. The length of the aganglionic segment was short in 33%, long in 45%, total colonic aganglionosis (TCA) in 11%, and involved the small intestine in 10%. Overall, 90% reported following a mixed diet, and 31% reported taking probiotics, with twice as many patients taking probiotics in the TCA group compared to standard HD. Mealtimes and behaviours around eating were affected by 61%, while 77% had established food items that worsened symptoms, and of these, 80% stated that they had worked these items out themselves. A high-fibre diet was followed by 24% and 18% a low-fibre diet. Symptoms were reported, particularly from dairy in 30%, fruits in 39%, pulses in 54%, and sugar in 48%. Conclusions: This first multinational survey on diet and bowel function in HD reports an association between certain dietary items with gastrointestinal symptoms. This study can support an improved understanding of the interaction between food items and bowel function in children with HD. We suggest a multidisciplinary approach to balance dietary exclusions and support adequate growth, preventing nutrition deficiencies and enhancing quality of life.<\/jats:p>","DOI":"10.3390\/children11091118","type":"journal-article","created":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T10:15:27Z","timestamp":1726136127000},"page":"1118","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Influence of Diet on Bowel Function and Abdominal Symptoms in Children and Adolescents with Hirschsprung Disease\u2014A Multinational Patient-Reported Outcome Survey"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3543-5974","authenticated-orcid":false,"given":"Judith","family":"Lindert","sequence":"first","affiliation":[{"name":"Department of Paediatric Surgery, University Rostock, Ernst-Heydemann-Str. 8, 18057 Rostock, Germany"},{"name":"Department of Specialist Neonatal and Paediatric Surgery Great, Ormond Street Hospital NHS Trust, London WC1N 3JH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Day","sequence":"additional","affiliation":[{"name":"Department of Specialist Neonatal and Paediatric Surgery Great, Ormond Street Hospital NHS Trust, London WC1N 3JH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"de Andres Crespo","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, University Rostock, Ernst-Heydemann-Str. 8, 18057 Rostock, Germany"},{"name":"UCL GOSH Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Amerstorfer","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, University Hospital Graz, Auenbruggerplatz 34, 8036 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Alexander","sequence":"additional","affiliation":[{"name":"SoMA e.V.\u2014Selbsthilfeorganisation f\u00fcr Betroffene von Morbus Hirschsprung und Anorektale Fehlbildungen Patient Organization, Munich, Blombergstr. 9, 81825 M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5675-9759","authenticated-orcid":false,"given":"Manouk","family":"Backes","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, Radboudumc Njjmegen, Geert Grooteplein Zuid 32, 6525 Nijmege, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlotta","family":"de Filippo","sequence":"additional","affiliation":[{"name":"Italian Association of Hirschsprung\u2019s Disease A.Mor.Hi, Via dei Castani 116, 00172 Rome, Italy"},{"name":"Institute of Agricultural Biology and Biotechnology, National Research Council (CNR), Via Moruzzi, 1, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7361-1572","authenticated-orcid":false,"given":"Andrzej","family":"Golebiewski","sequence":"additional","affiliation":[{"name":"Department of Surgery and Urology for Children and Adolescents, Medical University of Gdansk, 80-210 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4543-9298","authenticated-orcid":false,"given":"Paola","family":"Midrio","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Unit, Ca\u2019Foncello Hospital, Piazzale dell\u00b4Ospedale 1, 31100 Treviso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mazeena","family":"Mohideen","sequence":"additional","affiliation":[{"name":"SoMA Austria\u2014Selbsthilfeorganisation f\u00fcr Betroffene von Morbus Hirschsprung und Anorektale Fehlbildungen, Am-Ostrom-Park 11\/7, 1220 Wien, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Modrzyk","sequence":"additional","affiliation":[{"name":"Department of Children\u2019s Developmental Defects Surgery and Traumatology, Medical University of Silesia, 41-800 Zabrze, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anette","family":"Lemli","sequence":"additional","affiliation":[{"name":"SoMA e.V.\u2014Selbsthilfeorganisation f\u00fcr Betroffene von Morbus Hirschsprung und Anorektale Fehlbildungen Patient Organization, Munich, Blombergstr. 9, 81825 M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxana","family":"Rassouli-Kirchmeier","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, Radboudumc Njjmegen, Geert Grooteplein Zuid 32, 6525 Nijmege, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marijke","family":"Pfaff-Jongman","sequence":"additional","affiliation":[{"name":"Dutch Patient Association, Vereniging Ziekte van Hirschsprung, Hambakenwetering 15, 5231 \u2018S-Hertogenbosch, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karolina","family":"Staszkiewicz","sequence":"additional","affiliation":[{"name":"Polish Hirschsprung Facebook Group, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8581-5457","authenticated-orcid":false,"given":"Lovisa","family":"Telborn","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Lund University, Sk\u00e5ne University Hospital, 22100 Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5052-9944","authenticated-orcid":false,"given":"Pernilla","family":"Stenstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Lund University, Sk\u00e5ne University Hospital, 22100 Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karolin","family":"Holstr\u00f6m","sequence":"additional","affiliation":[{"name":"Swedish Patient Association-Hirschsprungs Sjukdom Patientf\u00f6rening, Sockerv\u00e4gen 25, 23253 Akarp, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Kohl","sequence":"additional","affiliation":[{"name":"Paediatric Gastroenterology, Paediatric Department, University L\u00fcbeck, Ratzeburger Alle 160, 23538 L\u00fcbeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joe","family":"Curry","sequence":"additional","affiliation":[{"name":"Department of Specialist Neonatal and Paediatric Surgery Great, Ormond Street Hospital NHS Trust, London WC1N 3JH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stavros","family":"Loukogeorgakis","sequence":"additional","affiliation":[{"name":"Department of Specialist Neonatal and Paediatric Surgery Great, Ormond Street Hospital NHS Trust, London WC1N 3JH, UK"},{"name":"UCL GOSH Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3303-6320","authenticated-orcid":false,"given":"Joseph R","family":"Davidson","sequence":"additional","affiliation":[{"name":"Department of Specialist Neonatal and Paediatric Surgery Great, Ormond Street Hospital NHS Trust, London WC1N 3JH, UK"},{"name":"UCL GOSH Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"zrab143","DOI":"10.1093\/bjsopen\/zrab143","article-title":"Comparative Cohort Study of Duhamel and Endorectal Pull-through for Hirschsprung\u2019s Disease","volume":"6","author":"Davidson","year":"2022","journal-title":"BJS Open"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1502","DOI":"10.1016\/j.jpedsurg.2021.01.043","article-title":"Long-Term Surgical and Patient-Reported Outcomes of Hirschsprung Disease","volume":"56","author":"Davidson","year":"2021","journal-title":"J. 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Ed."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/11\/9\/1118\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:54:57Z","timestamp":1760111697000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/11\/9\/1118"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,12]]},"references-count":31,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2024,9]]}},"alternative-id":["children11091118"],"URL":"https:\/\/doi.org\/10.3390\/children11091118","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,12]]}}}