Glossary On Diagnosis of Constipation

Diagnosis of constipation is largely done on the basis of the symptoms given by the patients. The main criteria for diagnosing constipation are that any 2 of the following must be present for a period of 12 weeks or more (whether continuous or not) in the last 12 months:

• Less than three bowel movements per week
• Stool that is hard and difficult to pass
• Straining hard at stools
• Sensation of incomplete evacuation
• Sensation of blockage in the anus or rectum

Constipation that is diagnosed on the basis of above symptoms needs further evaluation as to the cause and for the same, the physician may order certain investigations:

• Barium enema X-ray: X rays are taken after the inner lining of the bowel gets coated with a contrast dye.
• Sigmoidoscopy: In this test, the lower part of the large intestine (called sigmoid colon) is examined by passing a thin, flexible tube through the anus. The tube has a tiny camera at one end and this is used to visualize the inside of the colon.
• Colonoscopy: In this test, the entire large intestine (colon) is examined by passing a thin, flexible tube through the anus. The tube has a tiny camera at one end and this is used to visualize the inside of the colon.
• Serum electrolytes: To check for electrolyte imbalance
• Thyroid profile: To check for Hypothyroidism

Some other tests that may be done (though not very often) include:

• Defecography: A test done to evaluate how well the rectal muscles contract and eliminate the stool.
• Anorectal manometry: This test determines the efficiency of the co-ordination of muscles used to defecate.
• Colorectal transit study: This test examines how food passes through the colon and looks for signs of intestinal muscle dysfunction.