Doctor perform a history and physical examination in patients with constipation to identify alarm signs or symptoms.
Routine use of blood tests, radiography, or endoscopy is not require for patients with constipation without alarming signs or symptoms.
Physical examination for constipation
The physical examination include an abdominal and rectal examination, looking for signs of anemia, weight loss, abdominal masses, liver enlargement, or a palpable colon. The perineum should inspect for hemorrhoids, skin tags, fissures, rectal prolapse, or anal warts.
If you experience severe symptoms, doctor may request further tests, such as blood tests or thyroid tests, to diagnose or rule out other conditions.
Diagnosis test for constipation
Diagnostic tests such as blood tests, radiography, and endoscopy are not routinely recommendable in the initial evaluation of a patient with chronic constipation without alarming signs or symptoms.
Testing procedures used to diagnose chronic constipation include:
- Abdominal X-ray: is useful to produce images of the inside of the abdomen.
- Sigmoidoscopy: is a procedure to examine the rectum and lower portion of colon. During this procedure, doctor inserts a flexible tube with light into the anus for examination.
- Colonoscopy: is a diagnostic procedure useful to examine the rectum and entire colon with a flexible tube with light and camera.
- Anorectal manometry: is a useful procedure to examine anal sphincter muscle function. During this procedure, your doctor insert a flexible tube into the anus and rectum, and then inflate a small balloon attached at the tip of the tube. A machine measures pressure readings from the balloon as you squeeze, relax and push your rectum muscles; this gives an idea of how well the muscles and nerves in and around your rectum are working. This procedure measure the muscle coordination when moving the bowel.
- Colonic transit study: is a procedure useful to evaluate transit time (how well food moves) in the colon. During this procedure, you need to swallow a special capsule that show up on X-rays to take over the next few days. Take one or more X-rays to see how long capsule takes to pass through the digestive system. This helps to see for signs of intestinal muscle dysfunction.
- Defecography: Also known as, proctography is an X-ray of the rectum during defecation. During this procedure, doctor apply soft barium paste into the rectum. Then you require passing out this barium paste as stool. The barium shows up on X-rays and help reveal prolapse or muscle dysfunction and coordination.
Constipation scoring system to simplify evaluation and management of constipated patients. Agachan F, Dis Colon Rectum 1996;39:681-685.
Constipation scoring system
Based on the questionnaire, scores ranged from 0 to 30, with 0 indicating normal and 30 indicating severe constipation. A score of more than 15 can evaluate as constipation.