Constipation describes a condition where an individual experiences infrequent bowel movements, typically fewer than three times per week. Doctors use a structured approach to identify the underlying reasons for such digestive challenges. Understanding how doctors diagnose constipation involves looking at a person’s symptoms, medical history, physical examination findings, and various specialized tests.
Recognizing Symptoms
Individuals experiencing constipation often notice a reduction in the frequency of their bowel movements, with some passing stools fewer than three times weekly. The consistency of the stool also frequently changes, becoming hard, lumpy, or difficult to pass. Feelings of straining during bowel movements are common. Many people also report a sensation of incomplete evacuation.
When to Seek Medical Attention
Certain signs of constipation warrant medical evaluation. A sudden and unexplained change in bowel habits, particularly if it persists for several weeks, should prompt a visit. Unexplained weight loss occurring alongside constipation is another concerning symptom. The presence of blood in the stool, whether bright red or dark and tarry, also requires prompt medical consultation. Severe, persistent abdominal pain or constipation that does not improve with simple home remedies indicates a need for medical attention.
The Diagnostic Process
A healthcare provider begins the diagnostic process for constipation by taking a detailed medical history. This involves discussing dietary habits, daily fluid intake, and lifestyle factors, including physical activity levels. Information about current medications, as some drugs can induce constipation, is reviewed. The doctor also inquires about the patient’s typical bowel habits, including frequency, stool consistency, and any associated discomfort or straining.
Following the medical history, a physical examination is performed. This typically includes an abdominal examination to check for tenderness, bloating, or any masses. In some cases, a digital rectal examination may be conducted to assess the tone of the anal sphincter muscles and to check for any abnormalities in the rectum, such as impacted stool or structural issues. The doctor then discusses the gathered information with the patient, explaining the potential next steps.
Diagnostic Tests and Identifying Causes
To determine the underlying cause of constipation, doctors may order various diagnostic tests. Blood tests are frequently performed to rule out systemic conditions that can contribute to constipation, such as an underactive thyroid (hypothyroidism) or imbalances in electrolytes like calcium. An abdominal X-ray might be used to visualize the colon and assess the amount of stool present, indicating the severity of constipation or potential blockages. More specialized tests can investigate specific issues within the digestive system:
Colonoscopy or Sigmoidoscopy: Involves inserting a thin, flexible tube with a camera into the rectum and colon to visually inspect the lining for structural abnormalities, polyps, or inflammation that could impede stool passage.
Anorectal Manometry: Measures the pressure of the anal sphincter muscles and the coordination of rectal and anal muscles during defecation, helping to identify problems with muscle function.
Balloon Expulsion Test: Assesses the ability to expel a balloon filled with water from the rectum, evaluating the coordination of muscles involved in defecation.
Colonic Transit Studies: Tracks the movement of small markers through the colon over several days, revealing how quickly or slowly stool progresses through the large intestine, thereby identifying issues with intestinal motility.