Overview

Hirschsprung (HIRSH-sproong) disease is a condition in which nerve cells are missing in a baby's large intestine, resulting in bowel blockage. These nerve cells help move contents through the colon. Without them, the contents can back up and cause problems with passing stool. Hirschsprung disease is present at birth.

A newborn who has Hirschsprung disease usually can't have a bowel movement in the days after birth. In mild cases, there might not be symptoms until later in childhood. Rarely, Hirschsprung disease is first diagnosed in adults.

The treatment is surgery to bypass or remove the affected part of the colon.

Illustration showing a typical colon and rectum and with Hirschsprung disease

Hirschsprung's disease

In children with Hirschsprung disease, nerves fail to form in all or part of the large intestine. Without nerve tissue, waste cannot pass through the intestine. A typical colon swells and contracts, allowing stool to pass.


Symptoms

Symptoms of Hirschsprung disease depend on how bad the condition is. Usually symptoms start shortly after birth, but sometimes don't show up until later in life.

Typically, the most obvious symptom is a newborn's failure to have a bowel movement within 48 hours after birth.

Other symptoms in newborns may include:

  • Constipation or gas, which might make a newborn fussy.
  • Diarrhea.
  • Failure to thrive.
  • Stomach pain.
  • Swollen belly.
  • Vomiting, including a green or brown substance.

In older children, symptoms can include:

  • Long-lasting constipation.
  • Gas.
  • Failure to gain weight.
  • Fatigue.
  • Stomach pain.
  • Swollen belly.

Causes

The cause of Hirschsprung disease is unclear. It sometimes runs in families. In some cases, it might be associated with an altered gene.

Hirschsprung disease occurs when nerve cells in the colon don't develop all the way. Nerves in the colon control the muscle contractions that move food through the bowels. Without the contractions, stool stays in the large intestine.


Risk factors

Factors that may increase the risk of Hirschsprung disease include:

  • Having a sibling who has Hirschsprung disease. Hirschsprung disease can be inherited, meaning it's passed down through families. If you have one child who has the condition, future children could be at risk.
  • Being male. Hirschsprung disease is more common in males.
  • Having other inherited conditions. Hirschsprung disease can be related to certain inherited conditions, such as Down syndrome. It also can be related to irregularities present at birth, such as congenital heart disease.

Complications

Children who have Hirschsprung disease could develop enterocolitis, a serious intestinal infection. Enterocolitis can be life-threatening and should be treated right away.


August 14, 2025

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  3. Martin RJ, et al., eds. Selected gastrointestinal anomalies in the neonate. In: Fanaroff and Martin's Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant. 12th ed. Elsevier; 2025. https://www.clinicalkey.com. Accessed Nov. 6, 2024.
  4. Lopez ME, et al. Congenital aganglionic megacolon (Hirschsprung disease). https://www.uptodate.com/contents/search. Accessed Nov. 6, 2024.
  5. Constipation. National Institute of Diabetes and Digestive and Kidney Disease. https://www.niddk.nih.gov/health-information/digestive-diseases/constipation. Accessed Nov. 6, 2024.
  6. AskMayoExpert. Hirschsprung disease (child). Mayo Clinic; 2023.

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