DISCLAIMER: The following information has been gathered from various sources, including Medical Professionals and experts in the field. This is in no way a medical text, but can be used as a helpful set of information that will hopefully give you an understanding and basic knowledge of the subject.

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An introduction to the Digestive System

Parents Guide

An Introduction to the Digestive System

The gastrointestinal (GI) tract is the system of organs responsible for digesting food, absorbing nutrients, and removing waste. It is also known as the digestive tract or alimentary canal. The GI tract is a long, continuous tube that starts at the mouth and ends at the anus.

Digestion begins here with chewing and swallowing food.

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Anorectal Malformation

As the baby is growing, all organ systems are developing and maturing at different rates.

The gastrointestinal tract, urinary tract and uterus (womb), in girls, develop from the same clump of cells. Crucial steps occur between the sixth and tenth weeks of pregnancy to ensure the proper formation of the rectum and anus and reproductive organs.

If this process is incomplete or disrupted, it can lead to congenital conditions such as Anorectal Malformation (ARM), where the rectum and anus may not develop or separate properly from the urinary and/or reproductive systems.

Diagnosing Anorectal Malformation

Most babies with an ARM are not diagnosed prenatally (before birth). However, in some babies an ultrasound from the second trimester onwards can detect abnormalities within the urinary tract and lower pelvis, which may lead to a diagnosis of cloacal malformation. This is a rare and potentially even more complex type of ARM where the rectum, the vagina and urethra join together into a common passageway and end in a single channel.

(further information see ARM in Boys & ARM in Girls )

Soon after a baby is born a doctor will carry out a head to toe newborn baby check.

This includes examination of the baby’s perineum and genitals to check for birth defects.

The perineum is the area of the body that lies between the genitals (vaginal opening or scrotum) and anus.

Health care professionals use the passing of meconium (baby’s first stool) as part of the standard newborn checking procedure. If a problem is found the team will also routinely check other parts of the body. Some problems are known to be seen more frequently when an anorectal malformation has been found and it can be useful to diagnose them early.

When examining a new-born baby doctors may find signs of Anorectal Malformation:

No visible anus
Anal opening that is not in the normal location
Anus that is tighter or more narrow than normal
Anus which is blocked by a layer of tissue

In rare cases, the anus may be normal while the rectum is blocked or narrowed.

In addition, there may be an abnormal connection known as a fistula between the rectum and the perineum, the urinary tract or the genitals.

There may be delay in confirming a diagnosis of ARM if the baby is passing meconium via a fistula to the bladder or vagina.

Other signs and symptoms of Anorectal Malformation may be seen:

Baby is unsettled / distressed
Reluctant to take a full feed
A swollen tummy
Vomiting

Any of these should be reported to the healthcare team immediately.

Babies with signs of anorectal malformation need urgent medical treatment.

If a baby has an Anorectal Malformation, there are sometimes abnormalities in other parts of the body. This means the spine, the heart, the kidneys and bladder, and sometimes the arms and legs. It is usually better to find these early so investigations are usually performed.

These may could include:

Abdominal (tummy) X-rays.

A heart scan (called an Echo)

A renal / pelvic ultrasound

Ultrasound of the spine is often done too and is most useful in the first few weeks of life.
If it is likely to be helpful, an MRI (a scan that can take detailed pictures of the inside of the
body) is done. Often, enough information can be obtained without this initially.

Further investigations may be needed to diagnose other associated anomalies.

Treatment:

Many children with anorectal malformations will need surgery.

Some infants may need one operation whilst others are best treated with three operations.
In more complex anomalies it may be necessary to perform several operations over a longer
period. (further information see Investigations & Surgeries)

When your baby needs specialist care, it can feel overwhelming and frightening.

It’s natural to feel unsure about your role or what’s happening around you. The healthcare team is there to guide and support you. They will explain what is happening, answer your questions, and show you how you can be involved in your baby’s care.

You will be encouraged to take part in caring for your baby and to join in with discussions and decisions about your baby’s treatment. This can help you feel more confident and connected, even in a changing and sometimes stressful situation. This approach is often called family-centered or family-integrated care (1),

It means you’re an essential part of your baby’s care team.

Reference:
(1) Being a parent on the neonatal unit | Bliss