Which condition may necessitate the use of a colostomy or a colostomy bag?

Hirschsprung's disease is a congenital condition that affects the large intestine and causes problems with passing stool. In this condition, certain nerve cells are absent from a section of the intestine, leading to a lack of normal peristalsis and resulting in severe constipation or intestinal obstruction. When conservative management is unsuccessful, surgical intervention may be required, which can include the creation of a colostomy. A colostomy involves diverting the bowel through an opening in the abdominal wall, allowing waste to be collected in an external colostomy bag.

In contrast, while celiac disease, gastroesophageal reflux disease (GERD), and irritable bowel syndrome (IBS) can significantly impact the gastrointestinal tract, they typically do not necessitate the formation of a colostomy. Celiac disease is managed through dietary changes, GERD often requires lifestyle adjustments and medications, and IBS management focuses on symptom relief with dietary modifications and medications. Therefore, among the options provided, Hirschsprung's disease stands out as the condition most likely to require a colostomy due to its potential to cause significant intestinal issues that may require surgical intervention.