Hirschsprung’s Disease: How to Prevent Enterocolitis With Rectal Irrigations

Abstract

Hirschsprung’s disease is a condition where intestinal motility is compromised because of the absence of ganglion cells in the submucosal and myenteric plexus. A suction rectal biopsy is the definitive way to diagnose Hirschsprung’s disease. Enterocolitis is an inflammation of the small intestines and colon, which can be caused by bacterial overgrowth. Rectal irrigations are performed to help evacuate stool and gas from the small intestines and colon. It is important to perform adequate rectal irrigations on patients to prevent enterocolitis. Because of the importance of preventing enterocolitis, appropriate education is needed on Hirschsprung’s disease and enterocolitis and how to perform rectal irrigations effectively. A pilot study of 210 Neonatal Intensive Care Unit registered nurses was conducted to give education via poster presentation to deliver information on Hirschsprung’s disease and how to prevent enterocolitis with rectal irrigations. A pretest was administered before viewing the educational material. The test contained three questions on the topic. The poster was reviewed, and the questions were repeated utilizing a posttest to evaluate retention. Of the 210 Neonatal Intensive Care Unit registered nurses evaluated, there was an overall improvement on the three areas measured. The rates varied with each question. There was a 4.8% increase with Question 1, a 1.4% increase with Question 2, and a 10% increase with Question 3. These results showed an overall retention of the education provided. This was an effective way to educate a large group of nurses who provide bedside care to neonates with Hirschsprung’s disease. With this education, the nurses are better equipped to perform successful irrigations, thereby preventing enterocolitis.