Endoscopic Mucosal Resection Is Effective for Diagnosis of Adult Hirschsprung Disease

The diagnosis of Hirschsprung disease is sometimes delayed into adulthood when the affected colon segment is short. The diagnosis is commonly looked for by anorectal manometry, since patients with Hirschsprung disease usually fail to demonstrate the normal rectosphincteric reflex. However, some evidence has challenged the sensitivity of an absent reflex for the diagnosis.

In a study of 17 adult participants with constipation who underwent anorectal manometry, rectal suction biopsy, and endoscopic mucosal resection (EMR), rectal suction biopsy provided diagnostic submucosal tissue in 9 patients while EMR provided diagnostic tissue in all 17.

EMR was performed without submucosal injection using a cap and fitted-snare technique, with the biopsy …