Mumbai hospital performs endoscopic surgery to bring bowel relief to two-year-old

Mumbai: After almost two years of relying on daily enemas and medications, a two-year-old child suffering from severe constipation, weight loss and a dangerously swollen abdomen was finally diagnosed with an intestinal disorder , prompting surgical intervention.

Nitin, the child's father, said the first couple of months were not much of a problem, but then the child stopped passing stools altogether. "We rushed him to our family doctor and put him on treatment, but months passed and we could only see his condition deteriorate further," he said.

The child's parents, based in Sangamner, were advised to travel to Mumbai for further intervention. They consulted Dr Vibhor Borkar, a paediatric gastroenterologist referred by their local physician, who conducted a manometry and biopsy. These confirmed the child had Hirschsprung's disease—a congenital condition where nerve cells vital for bowel movement are missing from parts of the large intestine.

Dr Borkar said it was common for doctors to misdiagnose the condition, as symptoms like constipation and poor feeding are seen frequently in many infants and children. "It affects one in 5,000 to 10,000 children. There is no medical management for it, and it can prove life-threatening due to infections. In very young babies, delayed passage of the first green stool can be an early sign," he said.

Instead of subjecting the child to open surgery—where the affected portion of the intestine would have been removed and rejoined—doctors opted for a minimally invasive procedure called per-rectal endoscopic myotomy, which avoids any external scarring.

Nitin said the procedure was performed at Gleneagles Hospital in Parel and cost him over Rs 4 lakh. "We are still awaiting insurance claims," he said.

"The whole procedure is done endoscopically, where a small cut is made just inside the anus of the patient," Dr Shankar Zanwar, interventional gastroenterologist at the hospital, said. "From this cut, a tunnel is created within the layers of the intestine, and the non-functional segment lacking nerves is cut internally. The entry cut is then closed with clips. Since the procedure is done internally, there's no visible scar and the patient is pain-free afterwards. The entire procedure lasted around three hours."