RMDMCC – A Non-Surgical Dilatation Method for Low-Set Hirschsprung's Disease: Clinical Method and Preliminary Case-Series Documentation

RMDMCC (Rajatsubhra’s Manual Dilatation Method for Congenital Constipation) is a clinician-supervised, caregiver-performed progressive manual dilatation approach developed for selected children clinically and radiologically identified as having low-set Hirschsprung’s disease. The protocol uses gradual, tolerance-guided finger dilatation performed at home approximately 4–5 times daily, progressing from the little finger to larger fingers and ultimately to controlled two-finger widening of the constricted zone. Individual stages generally progress over approximately 4–6 days, with the advanced stage typically reached within 1–2 months and the overall programme continued for up to approximately six months. This paper documents the clinical method and preliminary observational experience in 32 children. Thirty were reported to achieve symptomatic resolution without surgery, 28 showed radiological improvement, and 2 required surgical referral. Caregivers also reported development of regular spontaneous bowel movements without continued stool-softener requirement in some children. These findings represent preliminary observational clinical experience and require prospective, systematically documented studies to establish safety, appropriate indications, durability of response, and comparative effectiveness.