<prompt> How will you confirm Hirschsprungs disease :Rectal biopsyColonoscopyBa enemaBa meal  <response>: The definitive diagnosis of Hirschsprungs disease is made by rectal biopsy. Samples of mucosa and submucosa are obtained at 1 cm, 2 cm, and 3 cm from the dentate line. In the neonatal period this biopsy can be performed at the bedside without anesthesia, because samples are taken in bowel that does not have somatic innervation and thus the procedure is not painful to the child. In older children, the procedure should be performed as an open rectal biopsy using IV sedation. The histopathologic features of Hirschsprungs disease are the absence of ganglion cells in the myenteric plexuses, increased acetylcholinesterase staining, and the presence of hyperophied nerve bundles. Ref : Hackam D.J., Newman K.D. 2010. Chapter 39. Pediatric Surgery. In T.R. Billiar, D.L. Dunn Eds, Schwazs Principles of Surgery, 9e. 