Digestive System Home > Diagnosing Hirschsprung's Disease

When diagnosing Hirschsprung's disease, a doctor will often recommend one or more special tests. Diagnostic tools, like x-rays, manometry, and a biopsy of the intestine, can all assist the doctor in determining the cause of symptoms like constipation. By diagnosing Hirschsprung's disease as soon as possible and beginning treatment at an early stage, more serious complications can often be prevented.

Diagnosing Hirschsprung's Disease: An Overview

To find out if a person has Hirschsprung's disease, the doctor will generally perform one or more tests, such as:
Depending on the child, the doctor may perform one or all of these tests.

Diagnosing Hirschsprung's Disease With a Barium Enema X-Ray

An x-ray is a black-and-white picture of the inside of the body. The picture is taken with a special machine that uses a small amount of radiation. For a barium enema x-ray, the doctor puts barium through the anus into the intestine before taking the picture. Barium is a liquid that makes the intestine show up better on the x-ray.
In some cases, instead of barium, another liquid, called Gastrografin®, may be used. Gastrografin is also sometimes used in newborns to help remove a hard first stool. This liquid causes water to be pulled into the intestine, and the extra water softens the stool.
In places where the nerve cells are missing, the intestine looks too narrow on the x-ray. If a narrow large intestine appears on the x-ray, the doctor knows Hirschsprung's disease might be the problem. More tests will help the doctor know for sure.

Diagnosing Hirschsprung's Disease With a Manometry

With a manometry, the doctor inflates a small balloon inside the rectum. Normally, the anal muscle will relax. If it doesn't, Hirschsprung's disease may be the problem. This test is most often done in older children and adults.
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Last reviewed by: Arthur Schoenstadt, MD
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