Symptoms in older children:

Constipation that gradually gets worse
Fecal impaction
Malnutrition
Slow growth
Swollen belly
Signs and tests

Milder cases may not be diagnosed until a later age.

During a physical examination, the doctor may be able to feel loops of bowel in the swollen belly. A rectal examination may reveal a loss of muscle tone in the rectal muscles.

fTests used to help diagnose Hirschsprung's disease may include:

Abdominal x-ray
Anal manometry (a balloon is inflated in the rectum to measure pressure in the area)
Barium enema
Rectal biopsy