Constipation

Talking to a healthcare provider — or anyone — about your bowel movements (or lack of them) may not be the most pleasant of topics. But know that your provider is there for you. They’re a trained healthcare professional who’s discussed just about every health topic you can think of with their patients.

Your provider will begin by asking you questions about your medical history, bowel movements, lifestyle and routines.

Medical history

These questions may include:

• What are your current and past diseases/health conditions?
• Have you lost or gained any weight recently?
• Have you had any previous digestive tract surgeries?
• What medications and supplements do you take for constipation relief or other disorders?
• Does anyone in your family have constipation or diseases of the digestive tract or a history of colon cancer?
• Have you had a colonoscopy?

Bowel movement history

These questions may include:

• How often do you have a bowel movement?
• What do your stools look like?
• Have you noticed any blood or red streaks in your stool?
• Have you ever seen blood in the toilet bowl or on the toilet paper after you wipe?

Lifestyle habits and routines

• What do you eat on a typical day for each meal?
• How often do you eat fruits and vegetables?
• How much water do you drink?
• What is your exercise routine?

Your provider will also perform a physical exam, which includes a check of your vital signs (temperature, pulse, blood pressure). They’ll use a stethoscope to listen to the sounds in your abdomen. They’ll also touch your abdomen to check for pain, tenderness, swelling and lumps.

Be aware that your provider may also perform a rectal exam. This is a finger exam of the inside of your rectum. It’s a quick check for any masses or problems that can be felt by a finger.

What lab tests and other medical tests may be done to find the cause of my constipation?

Your healthcare provider may not order any tests or may order many types of tests and procedures. Tests will depend on your symptoms, medical history, and overall health and what they think the cause might be. Most of the time, additional lab testing isn’t required for a diagnosis. However, your healthcare provider may choose to do more based on your symptoms.

• Lab tests: Blood tests and urine tests reveal signs of hypothyroidism, anemia and diabetes. A stool sample checks for signs of infection, inflammation and cancer.
• Imaging tests: Your provider may order a computed tomography (CT) scan, magnetic resonance imaging (MRI) scan or lower gastrointestinal tract series to identify other problems that could be causing your constipation. But these usually aren’t ordered.
• Colonoscopy: Your provider may perform a colonoscopy or sigmoidoscopy — an internal view of your colon with a scope. During this procedure, they may take a small sample of tissue (biopsy) to test for cancer or other issues and they’ll remove any polyps.
• Colorectal transit studies: These tests involve consuming a small dose of a radioactive substance, either in pill form or in a meal, and then tracking both the amount of time and how the substance moves through your intestines.
• Other bowel function tests: Your provider may order tests that check how well your anus and rectum hold and release stool. These tests include a certain type of X-ray (defecography), done to rule out causes of outlet dysfunction constipation, and the insertion of a small balloon into your rectum (balloon expulsion test and anorectal manometry).