Conditions We Treat

An anorectal malformation (ARM) is a term used to describe an anomaly related to the formation of the anus and rectum. It may also be called an imperforate anus. With an anorectal malformation, the anus and rectum do not develop properly, causing a range of abnormalities, including complex conditions requiring specialized treatment.

There can be associated anomalies; this is called VACTERL or VATER association. Patients with an anorectal malformation will have additional diagnostics to evaluate them for this association.

Cloaca is a rare and complex type of anorectal malformation. In babies born with this condition, the rectum, bladder and reproductive organs remain connected instead of separating during normal fetal development. Newborns are born with a common channel for the rectum, vagina and urinary tract.

The appearance of a cloacal malformation varies, depending on where the organs connect. The most common is having one opening where there should be three.

Children with cloaca may also have:

• An abnormal appearing anus
• More than one cervix, uterus or vagina
• Urological issues
• Heart or spinal cord problems
• Gastrointestinal issues

Hirschsprung disease is a congenital (present at birth) condition that affects nerve development in the lining of the rectum and, potentially, higher up in the intestines. Children with Hirschsprung disease have difficulty passing stool.

Most children with Hirschsprung disease show signs of the condition during their first weeks of life, usually within 24 – 48 hours after birth. Symptoms include no passage of stool, poor feeding, bloating and vomiting.

To diagnose Hirschsprung disease, our doctors will biopsy the rectum to look for normal nerves, called ganglion cells. If no ganglion cells are present, our surgeons can remove the diseased portion of your child’s rectum. We reconnect the intestines that have normal nerves to the anus. We use minimally invasive surgery whenever possible to allow babies to heal quickly after this procedure.

Idiopathic constipation is constipation without a known cause. It is a condition that can be managed with medication, enemas and, in some rare cases, surgery. Symptoms of idiopathic constipation can begin at any time, but can begin when your child starts eating solid foods or goes through potty training.

Symptoms of idiopathic constipation may include:

• A bloated or uncomfortable belly
• Hard, dry or very small bowel movements
• Going several days without a bowel movement
• Nausea or vomiting
• Pain or straining when trying to have a bowel movement
• Streaks or smears in your child’s underwear

Neurogenic bowel is the loss of normal bowel function caused by a nerve problem. Several different conditions that affect the lower part of the colon can cause neurogenic bowel, including congenital abnormalities, spinal cord injury, tethered cord, or spina bifida.  

There are two main kinds of neurogenic bowel:

• Reflex or spastic bowel problems: Occur when your child can’t relax their anal sphincter muscle voluntarily, causing unplanned bowel movements when the rectum becomes full
• Flaccid bowel problems: Cause reduced movements in the colon and may occur after a spinal cord injury, causing constipation or stool leakage

Symptoms may include:

• Constipation or diarrhea
• Difficulty having a bowel movement
• Fecal soiling
• Inability to tell when the bowel is full