Constipation

Constipation Diagnosis

Because constipation is such a common issue, most cases of it don’t require an official diagnosis. If you experience constipation, it may be helpful to start thinking about what might be causing the problem. Try asking yourself the following questions:

• What am I eating? Is my current diet rich in fiber?
• Am I drinking enough fluids? Am I dehydrated?
• How often do I exercise in a given week? Would I consider myself “active?”
• Do I ever purposely not use the bathroom when I have the urge to do so?

Any number of these, as well as the causes of constipation previously mentioned, may play a role in your constipation. Oftentimes, changing up your diet (see tips below), staying hydrated and active, and using the bathroom when you have the urge to do so can help get you back on track to regular bowel movements. If changing up your lifestyle doesn’t work, it may be time to see a healthcare provider. Additionally, if you have some of the more severe side effects of constipation, like rectal bleeding, abdominal bloating, or pain, it’s time to see a provider. It may be the sign of a more serious condition that can be treated.

Diagnosing chronic constipation

If you’re experiencing chronic constipation that’s interfering with your life or well-being, you should visit your healthcare provider. They will likely begin your visit by asking about your signs and symptoms (including their duration and severity) and taking stock of your personal and family medical histories. Receiving a diagnosis^[15] of chronic constipation requires that you’ve experienced at least two of the following symptoms over the course of the past three months:

• Under three bowel movements per week
• Straining to have bowel movements
• Feeling that you haven’t completely evacuated after having a bowel movement
• Having to frequently use treatments like laxatives, suppositories, or enemas to have bowel movements
• Feeling an anorectal blockage or that you’re “backed up”
• Having hard stools

These symptoms may also be a sign of other gastrointestinal conditions, such as irritable bowel syndrome (IBS). If your provider suspects that an underlying problem or health condition may be causing your constipation, they may use a number of tests or procedures to diagnose the cause of your chronic constipation. These may include^[16]:

• Blood and urine tests: Blood tests and urine tests (urinalysis) can help detect signs of systemic conditions, like low thyroid function (hypothyroidism), as well as other constipation-causing conditions, including diabetes, anemia (low red blood cell count), and high calcium levels.
• Imaging tests: X-rays, computerized tomography (CT) scans, and magnetic resonance imaging (MRI) can be used to take images of the intestines and colon and look for signs of blockages and other problems that may be causing constipation.
• Sigmoidoscopy and colonoscopy: These procedures involve using a slim, flexible tube with a light and camera to view the inside of the colon. The specialist performing these procedures may also take a small sample of tissue (called a biopsy) to be tested for cancer or other problems. Abnormal tissue growths (polyps) may also be removed during a sigmoidoscopy or colonoscopy.
• Colonic transit studies: In some of these procedures, you will swallow a capsule with a radiocarbon-activated material and a wireless recording device. The progress of this capsule through your colon is then recorded over a period of 24–48 hours (called scintigraphy). Because this capsule is visible on X-rays, this procedure can be used to see how long it takes materials to move through your digestive tract and detect signs of dysfunction in the intestinal muscles.
• Other bowel function tests: Other tests that may be used to monitor your bowel function include those that measure the coordination of the muscles used to move your bowels (anorectal manometry), record the amount of time it takes for you to empty your rectum (balloon expulsion test), reveal prolapse or muscle function/coordination problems (defecography), and diagnose problems that may be causing constipation (MRI defecography).