Neuronal Intestinal Dysplasia (NID)

Facts on the Condition

General description including
types, causes, prevalence, signs and symptoms

Childhood constipation may be due to either difficulty evacuating bowel motions, with faeces held up in the rectum for long periods, or due to slowed movement through the entire large bowel (colon). This second type of abnormality is termed “slow transit constipation”. Some of these children with slow transit constipation also have an abnormality of the nerves supplying the bowel, which is termed “Neuronal Intestinal Dysplasia” or “NID”. This tends to respond poorly to standard treatment.

Prevalence

Research reveals to date that one in 3000 infants and adults, of any gender, are diagnosed with NID. The condition has a genetic predisposition.
Signs and Symptoms

NID can affect young infants from birth, resulting in delay of the first stool (black meconium). Symptoms include constipation, nausea, bloating of the stomach, lack of appetite, bad breath and abnormal sleeping patterns. The child can develop faecal soiling which can interfere with parenting and infants’ welfare. Pressure from the full bowel can also cause incontinence of the bladder, often causing a confusing initial diagnosis of the condition.

Treatments, including role of specialists,
effects of treatments, use of devices, daily routines

NID is a chronic condition for which there is currently no cure. Patients diagnosed with this condition may undergo various treatments to assist in making their lives more comfortable. Laxatives may offer temporary relief for some of the children, however their effectiveness can be limited. Dietary manipulation is usually ineffective. High fibre may contribute to a worsening of symptoms for these children. Other treatments include nasogastric washouts, high doses of laxatives, and enemas. Surgery may be offered when standard medical therapies have failed.

Chait Button (Appendicostomy)

An appendicostomy (stoma) is a small opening in the abdomen wall, which leads to the caecum (large bowel). A tube is usually inserted through the appendicostomy (Chait button) with a small port which is covered by a cap. The child’s colon can then be directly accessed for bowel washouts two to three times a week. This form of treatment allows families to give the washouts at home, reducing stress and keeping hospital visits to a minimum.

Interferential Therapy

Interferential therapy is painless electrical stimulation performed by a physiotherapist. It stimulates the nerve supply of the bowel, and may assist in the reduction of constipation and incontinence. This treatment is typically performed three times per week for a four-week period.