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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 or for older adults with new-onset constipation. 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.
- X-ray of the anorectal area (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.
- Examination of the rectum and lower, or sigmoid, colon (sigmoidoscopy). In this procedure, your doctor inserts a lighted, flexible tube into your anus to examine your rectum and the lower portion of your colon.
- Examination of the rectum and entire colon (colonoscopy). This diagnostic procedure allows your doctor to examine the entire colon with a flexible, camera-equipped tube.
- Evaluation of anal sphincter muscle function (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.
- Evaluation of how well food moves through the colon (marker study or colorectal transit study). 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 your colon.
References
- Constipation. National Digestive Diseases Clearinghouse. http://digestive.niddk.nih.gov/ddiseases/pubs/constipation/. Accessed Dec. 16, 2010.
- Lembo AJ, et al. Constipation. In: Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4160-6189-2..X0001-7--TOP&isbn=978-1-4160-6189-2&about=true&uniqId=229935664-2192. Accessed Dec. 16, 2010.
- Wald A. Etiology and evaluation of chronic constipation in adults. http://www.uptodate.com/home/index.html. Accessed Dec. 16, 2010.
- Wald A. Management of chronic constipation in adults. http://www.uptodate.com/home/index.html. Accessed Dec. 16, 2010.
- Constipation. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/sec02/ch008/ch008b.html . Accessed Dec. 16, 2010.
- Hass DJ. Complementary and alternative medicine. In: Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4160-6189-2..X0001-7--TOP&isbn=978-1-4160-6189-2&about=true&uniqId=229935664-2192. Accessed Dec. 16, 2010.
- How much physical activity do adults need? Centers for Disease Control and Prevention. http://www.cdc.gov/physicalactivity/everyone/guidelines/adults.html. Accessed Dec. 16, 2010.
- Picco MF (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 20, 2010.
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