Certified Pediatric Nurse (CPN)

What history might support a diagnosis of Hirschsprung's disease in a child?

1. Anemia, abdominal distention, fecal soiling

2. Abdominal distention, constipation, foul smelling stools

3. Blood diarrhea, fever, vomiting

4. Irritability, severe abdominal cramps, fecal soiling

The correct answer is: Abdominal distention, constipation, foul smelling stools

The symptoms associated with Hirschsprung's disease typically include a combination of abdominal distention, constipation, and particularly foul-smelling stools. This condition arises due to the absence of ganglion cells in a segment of the colon, leading to a lack of normal peristalsis and resulting in obstruction and fecal accumulation. Abdominal distention occurs because the segment of the colon lacking nerve cells cannot effectively move stool along, causing it to build up. Constipation is a hallmark issue as the blockage prevents normal passage of feces. Moreover, the stools often have a foul odor due to the prolonged delay in their transit and the bacterial overgrowth that can happen in the distended segment of the colon. While other options present symptoms that may seem relevant to different gastrointestinal issues, they do not encapsulate the hallmark symptoms of Hirschsprung's disease as effectively. For instance, anemia and fecal soiling might be seen in other conditions but are not specific indicators of Hirschsprung's. Similarly, symptoms such as blood diarrhea and vomiting could indicate infections or other acute conditions rather than the chronic issues associated with Hirschsprung's disease. The combination of abdominal distention, constipation, and foul-smelling stools, on the other hand, offers the most consistent