Several of this month's papers look at uncommon conditions from the point of view of families. An editorial by parents of a child with precocious puberty reminds us that clinical and scientific uncertainty can be hard to bear. But even when there is little doubt about diagnosis and management, outcomes as seen by the sufferer may differ from that assumed by their clinicians.

A team from Great Ormond Street Hospital in London, UK report a 7–17 year follow up of 30 children with Hirschprung's disease divided according to whether their aganglionosis as total colonic (TCA) or rectosigmoid (RSA). Surgeons in the team studied continence by history, examination, and anal endosonography while a psychologist did the same using a semi-structured interview. The latter also investigated the children's competencies, behaviour, emotional state and self esteem.

Incontinence was depressingly common. The authors did not find an association with psychosocial maladjustment but caution that . . . [Full text of this article]

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