Enterocolitis complicating hirschsprungs disease: preliminary results of post-operative prophylaxis with colostrums

26 Oct 2010

BACKGROUND
The incidence of Hirschsprung’s associated enterocolitis ranges from 15% to 50% and can occur at any time from neonatal to adulthood period, pre- and post-surgical correction. Prophylaxis of post-op enterocolitis is matter of debate and no codified protocols have been established in this field. Colostrums have been reported effective to prevent NEC in animal models. The objective of this study is to evaluate the safety, tolerability, and efficacy of Colostrum associated with Morinda citrifoli extract in Hirschsprung’s disease patients as a prophylaxis of post-operative enterocolitis.

METHODS
Five patients with Hirschsprung’s disease were treated with De La Torre technique (4 pts with classic form, 1 pts with total colonic aganglionosis). Mean age at surgery was 3,27 months. Mean stay in hospital was 7,25 days. One month after surgery all patients received 550 mg of lyophilised bovine colostrums + 200 mg of Morinda citrifolia extract (COLOSTRO NONI – GUNA s.p.a. Milan, Italy) twice a day for 15 days, than once a day for 45 days.

RESULTS
All infants were evaluated in the outpatient clinic at 1,3 and 6 months after surgery. Occurrence and severity of episode of enterocolitis was evaluated according to literature. No episodes of enterocolitis occurred at mean follow up of 7 months.

CONCLUSIONS
These preliminary results seem to demonstrate the efficacy of colostrums. A randomized, placebo-controlled, double-blind trial will be necessary to confirm our limited data.