Although constipation is common in children, most children have no structural disease, and only a small percentage of them have an organic cause for diseases such as intestinal dysganglionosis. Of these the most common is Hirschsprung’s disease (HD), a disorder of the enteric nervous system’s development characterized by the absence of ganglion cells in the distal colon that causes functional obstruction. A diagnosis is established by rectal biopsy which requires surgery. In Colombia there are no clear guidelines for the study of these patients. This results in late diagnoses of almost half of the children with HD after one year of age. This article proposes recommendations and management guidelines for both the surgeon and the pathologist in an attempt to facilitate the study of patients with symptoms of constipation and suspected aganglionosis.