Which symptom should a nurse expect to find in an infant with Hirschsprung's disease?

In infants with Hirschsprung's disease, one of the hallmark symptoms is the presence of foul-smelling, ribbon-like stools. This disease is characterized by the absence of nerve cells (ganglia) in a segment of the bowel, leading to impaired intestinal motility in that area. As a result, fecal matter accumulates proximal to the affected segment, causing significant distension of the bowel and altering the consistency and formation of stools.

When stool finally passes through the narrowed segment, it can appear thin and ribbon-like due to the constricted passage. The foul smell is a result of the stagnant fecal matter that has decomposed in the colon, contributing to this specific presentation. This symptom is particularly significant as it not only indicates the bowel obstruction caused by Hirschsprung's but also helps differentiate this condition from others that may present similarly, guiding further assessment and treatment for the infant.