There is still no consensus on the definition of “chronic idiopathic constipation” (CIC). This makes diagnosis difficult.
A working definition of chronic idiopathic constipation
The working definition used for chronic idiopathic constipation is:
- Persistent constipation with fewer than three bowel movements per week
- Hard and lumpy stools
- nervous despite being properly managed for at least 12 months
- No other neurological or other medical conditions that may cause symptoms of constipation
exclude other conditions
Before the diagnosis of chronic idiopathic constipation is confirmed, anal and rectal deformities and developmental abnormalities, spinal defects, Hirschsprung’s disease, and non-retentive fecal soiling must be excluded.
Get a detailed history of the state. Red flags and warning signs that could mean other more serious conditions should also be ruled out. Warning signs include:
- blood in stool
- Symptoms appear after age 50
- Family history of colorectal cancer and inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease
- Presence of fever and low blood cell count
- Severe constipation that does not respond to treatment
- Unexplained weight loss
Other details such as laxative use and abuse (overuse), dosage, duration and results of laxative use, celiac disease, anorectal/spinal malformations will be checked.
Physical examination
A physical examination will follow. The patient’s (in children) growth, abdomen, spine, testicular reflexes, pelvic floor muscles, rectal and anal anatomy are all checked. The testicular reflex indicates that when you stroke the inside of your thigh, the testicle on the same side retracts.
It may be accompanied by a feeling of fullness or fullness in the abdomen, and may cause bowel sounds, pain, and the sensation of a hard lump in the abdomen. In cases of spinal abnormalities, there may be hairy or pigmented lesions all over the spine, causing the hips to become flattened or the spine to become curved and curved.
After the superficial examination, a digital rectal examination is performed. This involves gently inserting a gloved finger into the anus using a local anesthetic to examine the anus and rectum for tumors, masses, pain, or other abnormalities.
Investigation of chronic idiopathic constipation
First, obtain a plain x-ray film of the abdomen. This may indicate a fecal mass. There are also other imaging studies such as transit studies, barium contrast enemas, which show the intestinal transit time through the colon and rectum.
A spinal MRI scan is performed to rule out any defects or damage to the spine.
Anorectal manometry is performed to check tightness and pressure within the rectum and anus. This involves inserting a thin tube-like device to check the pressure within your rectum and anal sphincter. Colonic manometry may also be performed.
A rectal biopsy may be done during the rectal examination. This involves taking small tissue samples from your rectum and anus and examining them under a microscope.
A new diagnostic method uses smart pills that, when swallowed, pass through the gastrointestinal tract and send signals about intestinal transit, pH, temperature and pressure to an external receiver.