Caleb's Journey

Caleb's Journey

Over the next few months we'll explore Hirschprung Disease using Caleb, a fictitious patient and his parents Alyssa and Jake as our example. Follow along as we learn what Hirschprung Disease is, why people develop it, how it's treated and how it affects the lives of patients and families.

Understanding Hirschprung Disease

Understanding Hirschprung Disease 

During her pregnancy, Alyssa and Jake were incredibly excited to meet their baby boy! They were looking forward to having a son, but more than anything, just hoping for a healthy baby.  Caleb was born weighing in at 7 lbs, 3 oz. He was a squirming, wailing little pink baby and his parents felt blessed.

The nurses asked frequently how many times Caleb had pooped and peed.  The first day he was peeing just fine and learning to breastfeed, but he still hadn't pooped.  The second day, he had two very small poopy diapers but he wasn't all that interested in eating.  Alyssa, Jake and Caleb were sent home.

Bringing Home Baby

Over the next few days Caleb ate a little, but only had a few very small poopy diapers.  When he was five days old, he wouldn't eat at all. His little belly was round and hard, and he seemed very uncomfortable.   When Alyssa finally got him to eat something, he took two swallows and immediately threw up.  It wasn't normal baby spit up, it was forceful and green.

Jake called their pediatrician, who was concerned about dehydration and sent them to the emergency room for IV fluids.  They ran tests, took xrays, and poked poor Caleb.  It was easy to see he wasn't doing well-- he barely made a peep while getting blood drawn. Caleb had lost an entire pound since birth.  The doctors were concerned.  

The tests revealed that Caleb likely had Hirschsprung's Disease-- something Alyssa and Jake had never heard of.  The doctor came in and explained that with normal bowel function, the muscles and nerves work together to push the waste through the small intestine and the colon.  For patient's with HD, part (or in rare cases, all) of the colon lacks nerve cells.  This means that the poop can't move through that part.  This results in an intestinal blockage, which can be very dangerous and even life threatening. 

Normal colon vs. HD colon

 

With HD the end of the colon near the rectum lacks nerve cells.  The part of the colon before the part lacking nerve cells will become very distended as it gets filled with feces. Caleb would need to have a biopsy to confirm the diagnosis.  






Normal colon vs. HD colon image from: http://medlibes.com/entry/hirschsprungs-disease

Bringing home baby image from: http://www.babies.co.uk/life/bringing-home-your-new-baby/