The symptoms of Hirschsprung’s disease can vary significantly depending on the age of the child, the length of the affected bowel, and the presence of complications.
Early Symptoms in Newborns
Some cases show up in the first days of life due to clear signs of bowel blockage. Others appear weeks or months later, especially in mild forms. Knowing the early symptoms of Hirschsprung’s disease is key for quick diagnosis and timely surgery. This prevents life-threatening problems and improves long-term outcomes.
In newborns, one major sign is failure to pass meconium in the first 24 to 48 hours after birth. Meconium is the first dark stool most babies pass soon after delivery. In healthy infants, this happens without delay. In Hirschsprung’s disease, missing nerve cells stop normal stool movement. This leads to blockage. The baby often has a swollen belly, green or bilious vomiting, and refuses feeds. Severe cases may show enterocolitis. This is a dangerous bowel infection with fever, watery diarrhoea, and dehydration.
Symptoms in Older Infants and Toddlers
As babies grow, symptoms of Hirschsprung’s disease change. Older infants and toddlers often suffer from constant constipation that does not improve with diet, fluids, or common laxatives. Parents may notice bloating, fussiness, and feeding troubles. The child may pass only small, hard stools now and then. Sometimes, liquid stool leaks around the hard mass, called overflow incontinence. This can look like diarrhoea and confuse parents or doctors.
The belly often stays big due to trapped gas and stool. Some children feel pain or cramps after meals. Poor appetite and slow weight gain follow. Over time, long-term constipation and bowel swelling affect growth and health. If untreated, the bowel can tear or severe enterocolitis can happen. Both are emergencies.
Symptoms in Older Children
Older kids and even teens with untreated Hirschsprung’s disease may have subtle signs. They may deal with constant constipation, stool accidents, or stress from bathroom issues. Some need enemas or rectal washes to pass stool. This can cause shame, low confidence, and social withdrawal. A full medical history and proper tests prevent misdiagnosis as functional constipation.
Hirschsprung-Associated Enterocolitis
A serious symptom of Hirschsprung’s disease is enterocolitis. It can happen at any age but is most common in young children. It starts suddenly with fever, belly pain, bad-smelling diarrhoea, and dehydration. Bacteria and trapped stool in the bowel cause this. If untreated, it can lead to shock or bowel rupture. Quick treatment with antibiotics, bowel rest, and fluids is vital. Even after surgery, it can return, so close watch is needed.
Why Symptoms Vary
The symptoms of Hirschsprung’s disease often cause confusion and delay diagnosis. Constipation is common in kids, so doctors may blame diet, stress, or habits. Hirschsprung’s should be suspected when constipation is severe, does not improve, or comes with belly swelling, late meconium, or blockage signs.
The length of the bowel without nerves also changes symptoms. Short-segment disease affects only the lower bowel, so signs may appear later and seem mild. Long-segment or total colonic disease appears in newborns, with severe symptoms and high risk of complications. Children with large affected areas often have other problems or genetic syndromes.
Why Quick Action Matters
Recognising the symptoms of Hirschsprung’s disease early is essential for proper care. Parents should watch for bowel issues from birth, especially if family history or related conditions like Down syndrome exist. Doctors must stay alert in cases of stubborn constipation or unexplained blockage. Fast referral, correct tests, and early surgery greatly improve a child’s quality of life. The sooner the condition is found and treated, the better the outcome.
