In the newborn or young children that present with constipation, Hirschsprung disease should be an essential differential diagnosis (Ferry, 2013). In Hirschsprung disease, there is a congenital absence of ganglion cells found in the rectum and distal colon. This anomaly results in failure of the affected segment of the colon to relax thus causing functional obstruction that results in constipation. Hirschsprung disease is ruled out in the patient because this condition is usually diagnosed within the first few months of life and physical examination will reveal a tight anal canal, chronic constipation and failure to thrive (Ferry, 2013).
