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Hirschsprung’s Disease
                                                       & the Make-A-Wish Foundation




                                                                                     Amanda Metricarti
                                                                                                Period 9
http://www.wish.org/var/wish_user/storage/original/image/e8d70669a91b9456b72432fe262c204b.jpg    Rieger
Thesis Statement




             The Make-A-Wish Foundation sponsors children with
             life-threatening conditions by granting wishes, to
             enrich the human experience with hope, strength and
             joy.


http://ncwishball.org/images/dreams_homepage.png
Why this topic?


       “We make a living
      by what we get, but
       we make a life by
        what we give.”
      ~Winston Churchill
            http://img.docstoccdn.com/thumb/orig/49146955.png
            http://www.quotegarden.com/helping.html
Make-A-Wish

          The Make-Wish Foundation not only
         grants life wishes of children with life-
         threatening diseases, like cancer, but
         also other serious diseases that might
                  not take a child’s life.



http://t3.gstatic.com/images?q=tbn:ANd9GcSsi0K6iaG19TskBAbY6ypcNDbYhN6uy7UAdZMbh0yJMZ6JuuSN&t=1
Hirschsprung’s Disease (HD)


       *What is it?




http://digestive.niddk.nih.gov/ddiseases/pubs/hirschsprungs_ez/images/Digestive_Boy.jpg
What are the large intestine, colon,
                rectum, and anus?



         Large intestine

             colon

             rectum (connects)

             anus




http://www.consumerreports.org/health/resources/images/conditions/colon_default.jpg
Why does HD cause
                                     constipation?




                                                     Short-segment HD


              Healthy                                                                               Long-segment HD




http://digestive.niddk.nih.gov/ddiseases/pubs/hirschsprungs_ez/images/L_Intestine_Nerve_Cell1.jpg
http://digestive.niddk.nih.gov/ddiseases/pubs/hirschsprungs_ez/images/L_Intestine_Nerve_Cell2.jpg
http://digestive.niddk.nih.gov/ddiseases/pubs/hirschsprungs_ez/images/L_Intestine_Nerve_Cell3.jpg
What causes HD?

     Before birth

          cells grow in
          direction of anus

     With HD

          cells stop growing
          soon


http://nursingcrib.com/wp-content/uploads/hirschsprung-disease1.jpg
What are the symptoms?




                               Constipation
                               Intestinal
                               Obstruction



hdawarenessribbon.jpg
Symptoms in Newborns



           Vomiting

           Swelling of abdomen

           Gas

           Bloody diarrhea



http://digestive.niddk.nih.gov/ddiseases/pubs/hirschsprungs_ez/images/FemaleDoctor_Baby.jpg
Symptoms in Toddlers and
                        Older Children




   Not being able to go

   Slow growth

   Lack of energy

        -Anemia



http://digestive.niddk.nih.gov/ddiseases/pubs/hirschsprungs_ez/images/tiredgirl.jpg
How is HD diagnosed?




X-rays
Manometry
Biopsy
Tests
How is HD treated?
                                                                                The Pull-through
                                                                                Procedure




http://digestive.niddk.nih.gov/ddiseases/pubs/hirschsprungs_ez/images/L_Intestine_Procedure2.jpg
After the Pull-through
             Procedure



May have diarrhea for awhile

After awhile they will go less

Must learn to use muscle

Most learn to have better bowel control
Ostomy Surgery




http://digestive.niddk.nih.gov/ddiseases/pubs/hirschsprungs_ez/images/L_Intestine_Stoma1.jpg
Post- Ostomy Surgery



            They will feel better

            Learn to change

            May feel
            uncomfortable




http://digestive.niddk.nih.gov/ddiseases/pubs/hirschsprungs_ez/images/OstomyNurse_Boy.jpg
Diet and Nutrition
                                                                           Drink more fluids

                                                                           Small infants need feeding
                                                                           tubes

                                                                            through nose or incision
                                                                            in abdomen

                                                                           High-fiber foods

                                                                            whole-grain

                                                                            veggies
http://digestive.niddk.nih.gov/ddiseases/pubs/hirschsprungs_ez/index.htm
Infection


  fever
‱ swollen abdomen
‱ vomiting
‱ diarrhea
‱ bleeding from the rectum
‱ lack of energy
Works Cited
Bearden, Monica, RD. “Aplastic Anemia.” Consumer Health Complete. N.p., n.d. Web. 3 Nov. 2010. <http://
web.ebscohost.com//?vid=5&hid=109&sid=d027e13f-cf66-4d14-818d-57d19aeed73a
%40sessionmgr111&bdata=JnNpdGU9Y2hjLWxpdmU%3d#db=cmh&AN=HL96475>.

Garvey, John. “A Package Deal.” EBSCO Industries. N.p., n.d. Web. 3 Nov. 2010. <http://web.ebscohost.com//detail?
vid=4&hid=109&sid=a2c903a1-a7b2-4f6e-8d21-f125e8d6dc6d
%40sessionmgr110&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db=lfh&AN=44483269>.

“Leukemia.” Literary Reference Center. Colombia UP, 1 Dec. 2009. Web. 3 Nov. 2010. <http://web.ebscohost.com//?
vid=13&hid=109&sid=111d34c7-1cf2-4dfe-b0f7-a4d8dc01f148%40sessionmgr112&bdata=JnNpdGU9bHJjLWxpdmU
%3d#db=lfh&AN=39018085>.

Dimbleby, Kitty. “Finding a Rare Fellow Sufferer on the Website Was a Great Comfort.” Times [United Kingdom] 5 Nov.
2005: n. pag. Newspaper Source. Web. 23 Dec. 2010. <http://search.ebscohost.com/login.aspx?
direct=true&db=nfh&AN=7EH1813844530&site=ehost-live>.

Make-A-Wish. Make-A-Wish Foundation of America, 2006-10. Web. 21 Dec. 2010. <http://www.wish.org//>.

Grosfeld, J. L., P. Puri, and S. Montedonico. “Hirschsprung’s Disease: A Historical Perspective- 1691-2005 &
Hirschsprung’s Disease: Clinical Features.” Hirschsprung’s Disease and Allied Disorders. By Alexander M.
Holschneider. Ed. Gabriele Schroder. 3rd ed. Germany: Springer-Verlag, 2008. 1-7, 107-10. Print.

Hyman, Paul, M.D., et al. What I Need to Know about Hirschsprung’s Disease. Bethesda, Maryland: National Institutes
of Health, February 2010. National Digestive Diseases Information Clearinghouse. Web. 16 Feb. 2011. <http://
www.digestive.niddk.nih.gov>.

“Make-A-Wish.” Make-A-Wish. Make-A-Wish Foundation, 27 May 2008. Web. 17 Feb. 2011. <http://www.wish.org///
_facts_060823>.

Murphy, Nicole B. Hirschsprung’s Disease Solving the Puzzle. USA: 360 Digital, 2008. Print.

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SGP PowerPoint (15 slides)

  • 1. Hirschsprung’s Disease & the Make-A-Wish Foundation Amanda Metricarti Period 9 http://www.wish.org/var/wish_user/storage/original/image/e8d70669a91b9456b72432fe262c204b.jpg Rieger
  • 2. Thesis Statement The Make-A-Wish Foundation sponsors children with life-threatening conditions by granting wishes, to enrich the human experience with hope, strength and joy. http://ncwishball.org/images/dreams_homepage.png
  • 3. Why this topic? “We make a living by what we get, but we make a life by what we give.” ~Winston Churchill http://img.docstoccdn.com/thumb/orig/49146955.png http://www.quotegarden.com/helping.html
  • 4. Make-A-Wish The Make-Wish Foundation not only grants life wishes of children with life- threatening diseases, like cancer, but also other serious diseases that might not take a child’s life. http://t3.gstatic.com/images?q=tbn:ANd9GcSsi0K6iaG19TskBAbY6ypcNDbYhN6uy7UAdZMbh0yJMZ6JuuSN&t=1
  • 5. Hirschsprung’s Disease (HD) *What is it? http://digestive.niddk.nih.gov/ddiseases/pubs/hirschsprungs_ez/images/Digestive_Boy.jpg
  • 6. What are the large intestine, colon, rectum, and anus? Large intestine colon rectum (connects) anus http://www.consumerreports.org/health/resources/images/conditions/colon_default.jpg
  • 7. Why does HD cause constipation? Short-segment HD Healthy Long-segment HD http://digestive.niddk.nih.gov/ddiseases/pubs/hirschsprungs_ez/images/L_Intestine_Nerve_Cell1.jpg http://digestive.niddk.nih.gov/ddiseases/pubs/hirschsprungs_ez/images/L_Intestine_Nerve_Cell2.jpg http://digestive.niddk.nih.gov/ddiseases/pubs/hirschsprungs_ez/images/L_Intestine_Nerve_Cell3.jpg
  • 8. What causes HD? Before birth cells grow in direction of anus With HD cells stop growing soon http://nursingcrib.com/wp-content/uploads/hirschsprung-disease1.jpg
  • 9. What are the symptoms? Constipation Intestinal Obstruction hdawarenessribbon.jpg
  • 10. Symptoms in Newborns Vomiting Swelling of abdomen Gas Bloody diarrhea http://digestive.niddk.nih.gov/ddiseases/pubs/hirschsprungs_ez/images/FemaleDoctor_Baby.jpg
  • 11. Symptoms in Toddlers and Older Children Not being able to go Slow growth Lack of energy -Anemia http://digestive.niddk.nih.gov/ddiseases/pubs/hirschsprungs_ez/images/tiredgirl.jpg
  • 12. How is HD diagnosed? X-rays Manometry Biopsy Tests
  • 13. How is HD treated? The Pull-through Procedure http://digestive.niddk.nih.gov/ddiseases/pubs/hirschsprungs_ez/images/L_Intestine_Procedure2.jpg
  • 14. After the Pull-through Procedure May have diarrhea for awhile After awhile they will go less Must learn to use muscle Most learn to have better bowel control
  • 16. Post- Ostomy Surgery They will feel better Learn to change May feel uncomfortable http://digestive.niddk.nih.gov/ddiseases/pubs/hirschsprungs_ez/images/OstomyNurse_Boy.jpg
  • 17. Diet and Nutrition Drink more fluids Small infants need feeding tubes through nose or incision in abdomen High-fiber foods whole-grain veggies http://digestive.niddk.nih.gov/ddiseases/pubs/hirschsprungs_ez/index.htm
  • 18. Infection fever ‱ swollen abdomen ‱ vomiting ‱ diarrhea ‱ bleeding from the rectum ‱ lack of energy
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  • 22. Works Cited Bearden, Monica, RD. “Aplastic Anemia.” Consumer Health Complete. N.p., n.d. Web. 3 Nov. 2010. <http:// web.ebscohost.com//?vid=5&hid=109&sid=d027e13f-cf66-4d14-818d-57d19aeed73a %40sessionmgr111&bdata=JnNpdGU9Y2hjLWxpdmU%3d#db=cmh&AN=HL96475>. Garvey, John. “A Package Deal.” EBSCO Industries. N.p., n.d. Web. 3 Nov. 2010. <http://web.ebscohost.com//detail? vid=4&hid=109&sid=a2c903a1-a7b2-4f6e-8d21-f125e8d6dc6d %40sessionmgr110&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db=lfh&AN=44483269>. “Leukemia.” Literary Reference Center. Colombia UP, 1 Dec. 2009. Web. 3 Nov. 2010. <http://web.ebscohost.com//? vid=13&hid=109&sid=111d34c7-1cf2-4dfe-b0f7-a4d8dc01f148%40sessionmgr112&bdata=JnNpdGU9bHJjLWxpdmU %3d#db=lfh&AN=39018085>. Dimbleby, Kitty. “Finding a Rare Fellow Sufferer on the Website Was a Great Comfort.” Times [United Kingdom] 5 Nov. 2005: n. pag. Newspaper Source. Web. 23 Dec. 2010. <http://search.ebscohost.com/login.aspx? direct=true&db=nfh&AN=7EH1813844530&site=ehost-live>. Make-A-Wish. Make-A-Wish Foundation of America, 2006-10. Web. 21 Dec. 2010. <http://www.wish.org//>. Grosfeld, J. L., P. Puri, and S. Montedonico. “Hirschsprung’s Disease: A Historical Perspective- 1691-2005 & Hirschsprung’s Disease: Clinical Features.” Hirschsprung’s Disease and Allied Disorders. By Alexander M. Holschneider. Ed. Gabriele Schroder. 3rd ed. Germany: Springer-Verlag, 2008. 1-7, 107-10. Print. Hyman, Paul, M.D., et al. What I Need to Know about Hirschsprung’s Disease. Bethesda, Maryland: National Institutes of Health, February 2010. National Digestive Diseases Information Clearinghouse. Web. 16 Feb. 2011. <http:// www.digestive.niddk.nih.gov>. “Make-A-Wish.” Make-A-Wish. Make-A-Wish Foundation, 27 May 2008. Web. 17 Feb. 2011. <http://www.wish.org/// _facts_060823>. Murphy, Nicole B. Hirschsprung’s Disease Solving the Puzzle. USA: 360 Digital, 2008. Print.

Hinweis der Redaktion

  1. I have done my SGP on Hirschsprung&amp;#x2019;s Disease and the Make-A-Wish Foundation..\n
  2. (Just read it)\n
  3. My whole life my family has been taking in foster kids up until this year and it has really set an impact on my life and made me realize that just maybe it&amp;#x2019;s not so bad helping others who are in need. And then I came across this topic and thought that it would be really great to get involved with this foundation. I never really knew what the Make-A-Wish Foundation was about until I started researching it and it turned out to be really life-changing and inspirational, so I decided that I would get far with this topic. The picture on the left says, &amp;#x201C;welcome to the land of Make-A-Wish. where a child&amp;#x2019;s joyful dream becomes a reality. and a heartfelt wish really does come true!&amp;#x201D; and then the quote on the right, &amp;#x201C;we make a living by what we get, but we make a life by what we give.&amp;#x201D; i just thought that what my family has been doing my whole life and how it made a great impact on a few great people and i like to think that we &amp;#x201C;made their life&amp;#x201D; by giving them a family. \n
  4. (read the slide) The Make-A-Wish Foundation is world-wide and helps out families with diseased children. They grant wishes which helps out the mood of the family going through hard times because it adds joy to their child. Anyone can become involved with this foundation and can help sponsor a child and make their wish and that&amp;#x2019;s exactly what I did. My child that I sponsored has Hirschsprung&amp;#x2019;s Disease.\n
  5. HD is a disease of the large intestine that causes severe constipation or intestinal obstruction.\n\n
  6. The large intestine, which includes the colon and rectum, is the last part of the digestive tract. The large intestine&amp;#x2019;s main job is to absorb water and hold stool. The rectum connects the colon to the anus. Stool passes out of the body through the anus. At birth, the large intestine is about 2 feet long. An adult&amp;#x2019;s large intestine is about 5 feet long. \n
  7. People with HD have constipation because they lack nerve cells in a part or all of the large intestine. The nerve cells signal muscles in the large intestine to push stool toward the anus. Without a signal to push stool along, stool will remain in the large intestine. How severe HD is depends on how much of the large intestine is affected. Short-segment HD means only the last part of the large intestine lacks nerve cells. Long-segment HD means most or all of the large intestine, and sometimes the last part of the small intestine, lacks nerve cells. In a person with HD, stool moves through the large intestine until it reaches the part lacking nerve cells. At that point, the stool moves slowly or stops, causing an intestinal obstruction. \n
  8. Before birth, a child&amp;#x2019;s nerve cells normally grow along the intestines in the direction of the anus. With HD, the nerve cells stop growing too soon. Why the nerve cells stop growing is unclear. Some HD is inherited, meaning it is passed from parent to child through genes. HD is not caused by anything a mother did while pregnant.\n\n
  9. The main symptoms of HD are constipation or intestinal obstruction, usually appearing shortly after birth. Constipation in infants and children is common and usually comes and goes, but if your child has had ongoing constipation since birth, HD may be the problem.\n\n
  10. Newborns with HD almost always fail to have their first bowel movement within 48 hours after birth. Other symptoms include:\n-green or brown vomit\n-explosive stools after a doctor inserts a finger into the rectum\n-swelling of the belly, also known as the abdomen\n-lots of gas\n-bloody diarrhea\n
  11. Symptoms of HD in toddlers and older children include\nnot being able to pass stools without laxatives or enemas. A laxative is medicine that loosens stool and increases bowel movements. An enema is performed by flushing water, or sometimes a mild soap solution, into the anus using a special wash bottle.\nswelling of the abdomen.\nlots of gas.\nbloody diarrhea.\nslow growth or development.\nlack of energy because of a shortage of red blood cells, called anemia.\n \n
  12. HD is diagnosed based on symptoms and test results.\nA doctor will perform a physical exam and ask questions about your child&amp;#x2019;s bowel movements. HD is much less likely if parents can identify a time when their child&amp;#x2019;s bowel habits were normal.\nIf HD is suspected, the doctor will do one or more tests.\n
  13. HD is treated with surgery called a pull-through procedure. A surgeon removes the segment of the large intestine lacking nerve cells and connects the healthy segment to the anus. The pull-through procedure is usually done soon after diagnosis.\n\n
  14. Most children pass stool normally after the pull-through procedure. Children may have diarrhea for awhile, and infants and toddlers may develop diaper rash, which is treatable with diaper creams. Over time, stool will become more solid and the child will go to the bathroom less often. Toilet training may take longer. Children often must learn how to use the muscles of the anus after surgery. Some children may leak stool for awhile, but most will learn to have better bowel control as they get older.\n\n
  15. An ostomy allows stool to leave the body through an opening in the abdomen. Although most children with HD do not need an ostomy, a child who has been very sick from HD may need an ostomy to get better before the pull-through procedure.\nFor ostomy surgery, the surgeon first takes out the diseased segment of the large intestine. The end of the healthy intestine is moved to an opening in the abdomen where a stoma is created. A stoma is created by rolling the intestine&amp;#x2019;s end back on itself, like a shirt cuff, and stitching it to the abdominal wall. An ostomy pouch is attached to the stoma and worn outside the body to collect stool. The pouch will need to be emptied several times each day.\n
  16. Infants will feel better after ostomy surgery because they will be able to easily pass gas and stool.\nOlder children will feel better, too, but they must adjust to living with an ostomy. They will need to learn how to take care of the stoma and how to change the ostomy pouch. With a few changes, children with ostomies can lead normal lives. However, they may worry about being different from their friends. A special nurse called an ostomy nurse can answer questions and show how to care for an ostomy.\n\n
  17. After the pull-through procedure, children with long-segment HD need to drink more fluids. Now that the large intestine is shorter, or entirely gone, it is less able to absorb fluids the body needs. Drinking more helps make up for the loss. \nSome infants may need tube feedings for awhile. A feeding tube allows infant formula or milk to be pumped directly into the stomach or small intestine. The feeding tube is passed through the nose or through an incision in the abdomen.\nEating high-fiber foods can help reduce constipation and diarrhea. Fiber helps form stool, making bowel movements easier. High-fiber foods include whole-grain breads, vegetables, and fruits. Some children may need laxatives to treat ongoing constipation. Consult a doctor before giving a laxative to your child.\n\n\n
  18. People with HD can suffer from an infection of the intestines, called enterocolitis, before or after surgery. Symptoms include: fever, swollen abdomen, vomiting, diarrhea, bleeding from the rectum, and lack of energy. \n\n
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