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Constipation - Diagnosing constipation

Constipation is a very common condition. Your GP will not usually need to carry out any tests or procedures, but will confirm a diagnosis of constipation based on your medical history and your symptoms.

Your GP will ask you some questions about your bowel habits. Do not feel embarrassed about discussing this with your GP as it is important they are aware of all of your symptoms so they can make the correct diagnosis.

Your GP may also ask questions about your diet, level of exercise and whether there have been any recent changes in your routines.

Doctors define constipation in a number of ways:

  • opening the bowels less than three times a week
  • needing to strain to open your bowels on more than a quarter of occasions
  • passing a hard or pellet-like stool on more than a quarter of occasions

Physical examination

If your GP suspects that you may have faecal impaction (when dry, hard stools collect in your rectum), they may carry out a physical examination. See complications of constipation for more information about faecal impaction.

A typical examination will begin with you lying on your back while the GP feels your abdomen (tummy). You will then lie on your side while the GP performs a rectal examination using a lubricated, gloved finger. Your GP can feel for any stools that may have collected.

Your GP will rarely have to conduct an internal physical examination on a child. Instead, the diagnosis can normally be made by feeling their tummy.

Further tests

If you are experiencing severe symptoms, your doctor may request further tests, such as blood tests or thyroid tests, to diagnose or rule out other conditions.

Other tests you may have include:

  • an abdominal X-ray – where X-ray radiation is used to produce images of the inside of your abdomen
  • transit study examination – where you are given a course of special capsules that show up on X-rays to take over the next few days, and one or more X-rays are taken later on to see how long it takes for the capsules to pass through your digestive system
  • anorectal manometry – where a small device with a balloon attached to one end is inserted into your rectum and is attached to a machine that 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

As there is an increased risk of colorectal cancer in older adults, your doctor may also request tests to rule out a diagnosis of cancer, including a computerised tomography (CT) scan or colonoscopy.

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