2026-10-09T02:08:50Z https://api.figshare.com/v2/oai

oai:figshare.com:article/29587274 2026-09-29T10:13:31Z category_27235 category_24547 category_28774 category_27133 category_28807 category_27187 category_24838 category_27091 category_27139 item_type_12 month_year_09_2026

RMDMCC: A Non-Surgical Protocol for Low-set Hirschsprung’s Disease Rajatsubhra Mukhopadhyay (21706166) Traditional, complementary and integrative medicine not elsewhere classified Rural clinical health Global Indigenous studies health and wellbeing Primary health care Applications in health Community child health Infant and child health Health and community services Rural and remote health services Hirschprung’s disease Constipation -- Treatment Home based primary care constipation Chronic constipation RMDMCC (Rajatsubhra’s Manual Dilatation Method for Congenital Constipation) is a clinician-supervised, caregiver-performed, progressive manual dilatation method developed for selected children clinically and radiologically identified as having low-set Hirschsprung’s disease. The protocol uses gradual, tolerance-based manual anal–rectal dilatation together with supportive bowel management and regular clinical follow-up. Dilatation is generally performed 4–5 times daily, with progression from the little finger to progressively thicker fingers and subsequently to two-finger techniques as tolerated. Each stage generally continues for approximately 4–6 days. The final dilatation stage is generally reached over approximately 1–2 months, while overall clinical management and follow-up may continue for approximately 6 months. Osmotic stool softeners such as polyethylene glycol (PEG), lactulose, or lactitol may be used according to bowel pattern and clinical response. The preliminary documented experience includes 32 children. Descriptive observations include symptomatic resolution without surgery in 30/32 (93.75%), reported radiological improvement in 28/32 (87.5%), and surgical referral in 2/32 cases. Some caregivers reported regular spontaneous bowel movements without continued stool-softener requirement during follow-up. These findings are preliminary and observational. The documented case series was uncontrolled, diagnosis was largely based on clinical and radiological assessment, and histopathological confirmation was not documented for every case. Some outcomes were based partly on caregiver reports, and standardized long-term follow-up was incomplete. These observations should therefore not be interpreted as evidence that RMDMCC is equivalent or superior to established definitive surgical treatment for Hirschsprung’s disease. The current detailed clinical-method and preliminary case-series documentation is available as a 2026 Zenodo preprint: Mukhopadhyay, R. (2026). RMDMCC – A Non-Surgical Dilatation Method for Low-Set Hirschsprung's Disease: Clinical Method and Preliminary Case-Series Documentation. Zenodo. DOI: 10.5281/zenodo.23030017 RMDMCC was developed and clinically practiced at Child Health Care Arambag (CHCA), West Bengal, with institutional support from Sri Yoga Center Trust – Kunarpur. This Figshare record provides earlier and supporting documentation related to the continuing development and clinical documentation of RMDMCC. 2025-07-17T16:57:46Z Text Preprint 10.6084/m9.figshare.29587274.v4 https://figshare.com/articles/preprint/_b_RMDMCC_A_Non-Surgical_Protocol_for_Low-set_Hirschsprung_s_Disease_b_/29587274 CC BY 4.0