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Tests and diagnosis
By Mayo Clinic staffYour doctor will take your medical history, perform a physical exam and ask about any prescription or over-the-counter medications you're taking. Your doctor will also want to rule out several conditions in diagnosing constipation. These include a blockage in your small intestine or colon (intestinal obstruction), a narrowing of the colon, an endocrine condition such as hypothyroidism, or an electrolyte disturbance, such as excessive calcium in the blood (hypercalcemia).
Extensive testing is usually reserved for people with severe symptoms. You may undergo these diagnostic procedures:
- Barium enema X-ray. In this test, the lining of your bowel is coated with a contrast dye (barium) so that your rectum, colon and sometimes a part of the small intestine can be clearly seen on an X-ray.
- Defecography. In this X-ray procedure, your doctor will fill your rectum with a soft paste with the same consistency as stool. As you expel the paste, X-rays are taken to evaluate the completeness of stool elimination and rectal muscle contractions.
- Sigmoidoscopy. In this procedure, your doctor inserts a lighted, flexible tube into your anus to examine your rectum and lower portion of your colon.
- Colonoscopy. This diagnostic procedure allows your doctor to examine the entire colon with a flexible, camera-equipped tube.
- Anorectal manometry. In this procedure, your doctor inserts a narrow, flexible tube into your anus and rectum, and then inflates a small balloon at the tip of the tube. The device is then pulled back through the sphincter muscle. This procedure allows your doctor to measure the coordination of the muscles you use to move your bowels.
- Marker studies or colorectal transit studies. In this procedure, you'll swallow a capsule containing markers that show up on X-rays taken over several days. Your doctor will look for signs of intestinal muscle dysfunction and how well food moves through the colon.
- Constipation. National Digestive Diseases Information Clearinghouse. http://digestive.niddk.nih.gov/ddiseases/pubs/constipation/. Accessed Nov. 10, 2008.
- Wald A, et al. Treatment of chronic constipation in adults. http://www.uptodate.com/home/index.html. Accessed Nov. 10, 2008.
- Wald A, et al. Etiology and evaluation of chronic constipation in adults. http://www.uptodate.com/home/index.html. Accessed Nov. 10, 2008.
- Pohl D, et al. Pharmacologic treatment of constipation: What is new? Current Opinion in Pharmacology. 2008;8:724.
- Constipation. American Society of Colon and Rectal Surgeons. http://www.fascrs.org/patients/conditions/constipation. Accessed Nov. 10, 2008.
- Constipation. American Gastroenterological Association. http://www.gastro.org/wmspage.cfm?parm1=687. Accessed Nov. 10, 2008.
- Bharucha A. Constipation. Best Practice and Research Clinical Gastroenterology. 2007;21:709.
- Patel S, et al. Constipation. In: Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2006. http://ww.mdconsult.com/das/book/body/113047217-6/780888909/1389/98.html?printing=true. Accessed Nov. 10, 2008.
- Culbert T, et al. Integrative approaches to childhood constipation and encopresis. Pediatric Clinics of North America. 2007;54:927.
