Diagnosis of Constipation:

Occasional constipation does not justify visiting a doctor, but may become necessary to seek medical attention if the constipation becomes a persistent problem. The physician will first take a medical history and ask about the symptoms, duration, frequency and consistency of the stools and bowel movements. Next, the doctor will examine the abdomen for any sign of a hardened mass and conduct a digital rectal exam (DRE). During the DRE, the doctor will insert a gloved, lubricated finger into the rectum to feel for any tenderness, obstruction or blood. In some cases, blood and thyroid tests may be necessary.

More extensive testing is reserved for people with severe symptoms. This testing may include a barium enema x-ray, sigmoidoscopy, colonscopy, colorectal transit study or anorectal function tests (anorectal manometry and defecography). A barium enema x-ray involves viewing the rectum, colon and lower part of the small intestine after filling the organs with a chalky liquid to make these areas visible. A sigmoidoscopy is an examination of the rectum and lower colon (sigmoid) using a viewing instrument called a sigmoidoscope.

A colonoscopy is an examination of the rectum and entire colon using an instrument called a colonscope. The colorectal transit study shows how well food moves through the colon. After swallowing capsules containing small markers, the markers’ movements are viewed via an x-ray.

An anorectal manometry evaluates anal sphincter muscle function. A catheter or air-filled balloon inserted into the anus is slowly pulled back through the sphincter muscle to measure muscle tone and contractions. Defecography is an x-ray of the anorectal area that identifies anorectal abnormalities, evaluates rectal muscle contractions and relaxation.