Table of Contents
- Constipation facts
- What is constipation?
- What causes constipation?
- Medications that cause constipation
- Other causes of constipation
- Other causes of constipation (Continued)
- What are constipation symptoms?
- How is constipation diagnosed (evaluated)?
- Exams and tests
- Imaging studies and other tests
- What treatments are available for constipation?
- Dietary fiber and bulk-forming laxatives to treat constipation
- Dietary fiber and bulk-forming laxatives to treat constipation (Continued)
- Other laxatives to treat constipation
- Other laxatives and OTC products to treat constipation
- Other laxatives and OTC products to treat constipation (Continued)
- Prescription drugs to treat constipation
- Other treatments for constipation?
- What is the approach to the evaluation and treatment of constipation?
- When should I seek medical care for chronic constipation?
- What is new in the treatment of constipation?
Exams and tests
A careful medical history from a patient with constipation is critical for many reasons, but particularly because it allows the physician to define the type of constipation. This, in turn, directs the diagnosis and treatment. For example, if defecation is painful, the physician knows to look for anal problems such as a narrowed anal sphincter or an anal fissure. If small stools are the problem, there is likely to be a lack of fiber in the diet. If the patient is experiencing significant straining, then pelvic floor dysfunction is likely.
The medical history also uncovers medications and diseases that can cause constipation. In these cases, the medications can be changed and the diseases can be treated.
A careful dietary history-which may require keeping a food diary for a week or two-can reveal a diet that is low in fiber and may direct the physician to recommend a high-fiber diet. A food diary also allows the physician to evaluate how well a patient increases his dietary fiber during treatment.
A physical examination may identify diseases (for example, scleroderma) that can cause constipation. A rectal examination with the finger may uncover a tight anal sphincter that may be making defecation difficult or it may find that the muscles of the pelvic floor do not relax normally. If a stool-filled colon can be felt through the abdominal wall, it suggests that constipation is severe. Stool in the rectum suggests a problem with the anal, rectal, or pelvic floor muscles.
Blood tests may be appropriate in evaluating patients with constipation. More specifically, blood tests for thyroid hormone (to detect hypothyroidism) and for calcium (to uncover excess parathyroid hormone) may be helpful.
Large amounts of stool in the colon usually can be visualized on simple X-ray films of the abdomen, and the more severe the constipation, the more stool is visualized.
A barium enema (lower gastrointestinal [GI] series) is an X-ray study in which liquid barium is inserted through the anus to fill the rectum and colon. The barium outlines the colon on the X-rays and defines the normal or abnormal anatomy of the colon and rectum. Tumors and narrowings (strictures) are among the abnormalities that can be detected with this test. Continue Reading