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Your health care professional may ask the affected individual several questions, conduct a physical exam, and perform certain lab tests to find out the possible causes of his or her constipation.

Answers to these questions will help the doctor assess the affected person's condition and plan the treatment options.

• What are your normal bowel habits?
• How long have you had difficulty in passing stool?
• When was the last time you passed stool?
• Are you able to pass gas?
• Do you experience any abdominal or anal pain?
• Could you indicate with your finger the site of your pain?
• How would you describe your abdominal pain?
• Have you noticed any changes in your body temperature?
• Have you tried any medication? Did it help?
• Do you usually take laxatives or an enema? If yes, what type of laxatives and how many tablets per day do you usually take?
• Do you feel that you always need laxatives to pass stool?
• Do you have any other symptoms?
• Any changes in your appetite?
• Any changes in your body weight?
• Do you feel better after passing stools?
• Do you feel sick? Have you thrown up?
• Any hospital admission or investigations for similar illness?
• Are you pregnant?
• Do you smoke cigarettes? When did you start smoking? How many cigarettes do you smoke per day?
• Do you drink alcohol? Coffee? Tea?
• How much?
• Do you use drugs? Any medications?
• Have you ever had surgery? What surgery? When?
• Any joint pain, eye problems, back or neck pain, or skin changes?
• Do you usually prefer warm weather?
• Do you usually feel tired easily?
• Do you have a family history of constipation or bowel cancer?
• Have you ever been screened for colon cancer?

The health care professional will examine the patient's abdomen, anus, and other body systems including the nervous system, the thyroid gland (for any goiter), and the musculoskeletal system. What parts the health care professional examines will depend on the patient's answers to the questions and any history that may suggest certain disorders.

The health care professional will decide which tests the patient needs based on his or her symptoms, history, and exam. These tests will help assess the actual cause of the problem. The most commonly used tests may include the following:

• Examining a stool sample under a microscope
• Complete blood count (CBC) and blood film
• Thyroid function tests if hypothyroidism is suspected

Imaging

• Upright plain X-ray of the chest and abdomen may show free air from intestinal perforation, or signs of intestinal obstruction
• Barium enema may reveal a disease of the colon
• Assessment of food movement may demonstrate a prolonged and delayed transit time

• Sigmoidoscopy may help to detect problems in the rectum and lower colon. The doctor will insert a flexible lighted instrument through the anus to visualize the rectum and the lower intestine.
• Colonoscopy involves the passage of a flexible tube (endoscope) into the colon; your doctor can suspect the diagnosis of irritable bowel syndrome by ruling out more serious disorders. The doctor also may take tissue biopsies for further studies to assess the cause underlying your symptoms.

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