## **Core Concept**
Hirschsprung's disease is a congenital condition characterized by the absence of ganglion cells in the distal bowel, leading to a functional obstruction. Rectal washouts are a treatment approach to clear the bowel of stool and reduce the risk of enterocolitis.

## **Why the Correct Answer is Right**
The correct answer, **D. Normal saline**, is used for rectal washouts in Hirschsprung's disease because it is isotonic and does not cause electrolyte imbalances. Normal saline helps to gently clear the rectum and sigmoid colon of stool without causing irritation or damage to the mucosa. This approach is crucial in managing the condition and preventing complications like enterocolitis.

## **Why Each Wrong Option is Incorrect**
* **Option A:** *Hypertonic saline* could potentially cause mucosal irritation and is not typically used for rectal washouts due to the risk of disrupting the delicate balance of electrolytes and potentially causing tissue damage.
* **Option B:** *Hypotonic saline* might cause cellular swelling and could potentially disrupt the normal functioning of the bowel mucosa, making it less suitable for rectal washouts.
* **Option C:** *Glucose solution* is not typically used for rectal washouts as it does not offer any specific advantage over normal saline and could potentially provide a medium for bacterial growth.

## **Clinical Pearl / High-Yield Fact**
A key point to remember is that rectal washouts are an important part of the management of Hirschsprung's disease, especially in the preoperative period or during acute episodes of enterocolitis. The use of **normal saline** is preferred due to its isotonic nature, which minimizes the risk of complications.

## **Correct Answer:** . Normal saline