Case Study: How Doctors Saved A Baby's Life Who Could Not Poop Naturally For Two Years!

The baby started to suffer from severe constipation when he turned a month old. His stomach would swell and he would be in a lot of pain and distress. This continued for two years. Read on to know what happened next...

In a strange case, a baby was saved from a life-long health complication by doctors of a prominent hospital in Mumbai. A rare and scarless procedure known as per-rectal endoscopic myotomy (PREM) was performed on the two-year-old patient, who suffered from a congenital condition that made him unable to pass stool naturally. As such, he had to be completely dependent on daily enemas for over two years. The baby, who suffered from Hirschsprung's disease -- a birth defect where nerve cells are missing in parts of the large intestine, making it difficult to pass stool -- is now leading a normal life. Not only has he been relieved of incessant abdominal pain and swelling, he also no longer needs further medical intervention. Read on to know more about the case.

Severe Constipation Issues Soon After Birth

The baby's parents were naturally overjoyed with the birth of their first child: a cheerful and playful baby that brought them immense happiness. But, soon after he turned a month old, the baby's parents began to notice that he suffered from severe constipation. He would not pass stool for as long as eight straight days, causing him a lot of discomfort and pain. Despite multiple medications and daily enemas given to the child by their family doctor in Nashik, his condition failed to improve.

Tummy Problems

According to the parents, the baby's tummy would often swell with gas; he also could not gain the necessary weight. That is when the family decided to travel to Mumbai. This was in December 2024. Upon reaching, they met with one Dr Vibhor Borkar, who suspected it to be a case of Hirschsprung's. Diagnostic tests like barium enema, endoscopy biopsy, and manometry were recommended, which confirmed the condition. The baby's treatment started at Gleneagles Hospitals, Parel, Mumbai.

A Case Of Hirschsprung's Disease

Dr Borkar, a paediatric gastroenterologist at the hospital explained that Hirschsprung's disease occurs when the nerve cells -- also known as ganglion cells -- in the lower part of the large intestine fail to develop. It can cause stool to accumulate, leading to blockage and chronic constipation. This disease apparently affects 1 in 5,000 to 10,000 children.

In a statement shared by the hospital, Dr Borkar said there is no medical management for this condition, and it can even become life-threatening due to the risk of infections. "In babies, delayed passage of the first green potty (meconium) can be an early sign. Older children usually suffer from swollen stomachs, vomiting, poor weight gain, and constant constipation; some may suffer from infections. Standard treatment requires major surgery that is either open or laparoscopic, where the affected part of the intestine is removed and rejoined. In this child's case, however, we used a minimally-invasive technique called PREM, which avoids any external scarring."

A New Lease Of Life For The Patient

The procedure has freed the child of all symptoms. He is apparently eating well and even passing stools without enema. According to the doctor, had the child not been treated at the right time, he could have developed complications like enterocolitis, infection, and poor weight gain. "Though this is a congenital condition, antenatal diagnosis is extremely difficult and the child becomes symptomatic only after birth," the doctor said.

Per-Rectal Endoscopic Myotomy (PREM)

Dr Shankar Zanwar, an interventional gastroenterologist at the hospital said that this procedure is done under general anesthesia. They were helped by Dr Aditya Prabhudesai and Dr Dhanashree Karkhanis.

"The whole procedure is done endoscopically. A small cut is made just inside the anus of the patient. From this cut, a tunnel is made within the layers of the intestine and a nonfunctional segment of the intestine -- which lacks nerves -- is cut internally. The entry cut is then closed with clips. No scar or cut is seen on the body, and the patient is pain-free after the procedure," Dr Zanwar explained.

The entire process lasted three hours. Globally, only 13 such procedures have been performed, and this is the first such case to be treated by an endoscopic method in Mumbai. The child was discharged within two days. His stomach has now flattened and he can pass stool normally.