Which exams and studies are included in the workup of constipation?

Updated: Mar 30, 2020
  • Author: Marc D Basson, MD, PhD, MBA, FACS; Chief Editor: BS Anand, MD  more...
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An extensive workup of the constipated patient is performed on an outpatient basis and usually occurs after approximately 3-6 months of failed medical management. Anorectal tests should be used to evaluate for defecatory disorders if over-the-counter agents do not relieve the constipation. [3]

Features of the workup are as follows:

  • Rectal and perineal examination should already have been performed but should be repeated

  • Laboratory evaluation does not play a large role in the initial assessment of the patient

  • Imaging studies are used to rule out acute processes that may be causing colonic ileus or to evaluate causes of chronic constipation

  • In patients with acute abdominal pain, fever, leukocytosis, or other symptoms suggesting possible systemic or intra-abdominal processes, imaging studies are used to rule out sources of sepsis or intra-abdominal problems

  • Lower gastrointestinal (GI) endoscopy, colonic transit study, defecography, anorectal manometry, surface anal electromyography (EMG), and balloon expulsion testing may be used in the evaluation of constipation

See Workup for more detail.

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