Hirschsprung's disease is caused by a developmental failure of the parasympathetic plexuses of Auerbach and Meissner in the gut, leading to constipation and gut dilation.

It is a condition that usually manifests itself in the immediate neonatal period by the failure of passage of meconium followed by obstructive constipation. In some instances, when only a small segment of the rectum is affected, the build up of pressure may permit the occasional passage of stools, even intermittent bouts of diarrhoea.