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Hirschsprung's-Associated Enterocolitis (HAEC) Alert for clinicians

Information alert box Hirschsprung's-Associated Enterocolitis (HAEC) Alert

It can be difficult to tell whether a child with Hirschsprung's has a tummy bug or enterocolitis.When in doubt, it is best to assume enterocolitis and seek treatment.

Advice for parents / carers | Bowel washout

Consider Hirschsprung's-Associated Enterocolitis (HAEC)

  • This child has Hirschsprung's disease
  • This child is known to the Oxford Children's Hospital Paediatric Colorectal Team
  • HAEC can lead to sepsis, morbidity and mortality

Signs of Hirschsprung's-Associated Enterocolitis

  • Reduced feeding and lethargy
  • Distended abdomen
  • Vomiting
  • Diarrhoea (signs of gastroenteritis)
  • Bloody or mucous-filled stools
  • Pyrexia

Immediate care

  • Stop oral feeding
  • Continue dioralyte / water if tolerated


  • Blood tests (FBC, electrolytes, CRP, glucose, blood culture)
  • Abdominal X-ray
  • Urine and stool culture


  • Cannulate and start IV fluids (maintenance +/- bolus)
  • Start IV ceftriaxone and metronidazole
  • Pass an NG tube, leave on free drainage
  • Rectal washout: most parents will be trained to do this, please support them with space and equipment

Contact Paediatric Surgical Team (via Switchboard 0300 304 7777 Bleep 1820)

Last reviewed:12 December 2023