History: Individuals will report problems having bowel movements or complain of hard, dry stools. Sensations of fullness or pressure in the rectum and a frequent urge to defecate are also common. After prolonged constipation, there may be a sense of stomach (epigastric) fullness along with nausea, belching, stomach distention, return of stomach contents into the mouth (regurgitation), or abdominal discomfort. Long-term, untreated constipation may produce headache, dizziness (vertigo), general weakness and discomfort (malaise), loss of appetite (anorexia), or a bad taste in the mouth. Physical exam: The exam may reveal increased anal canal muscle tone and crack-like lesions on the anus (anal fissures). The individual may also have a distended abdomen and there could be an accumulation (impaction) of hardened, dry (inspissated) feces that can be felt in the area of the lower bowel (rectum, or sigmoid/transverse colon). Tests: Tests are not ordinarily needed to ascertain that an individual has constipation because the history and physical exam will provide adequate information. However, in some cases, tests may be performed to identify the cause of constipation. Thyroid and parathyroid function tests may be performed along with a test for urinary tract infection. The interior of the colon can be inspected by inserting a flexible optic instrument (endoscope) through the rectal opening and up into the colon (colonoscopy). The colon can also be visualized on x-ray following a barium enema. Functional tests may include measurement of transit time through the colon (colorectal transit time) using radiopaque markers (colonic scintigraphy) or recording abnormal electrical activity of the colon (electromyography). Anorectal morphology and dynamics can be studied during defecation using a barium paste that reproduces stool consistency (defecography). |
Source: Medical Disability Advisor