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PRIMARY CARE SERVICES

Diagnosis & Treatment

Constipation

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How is Constipation Diagnosed?

Diagnosis

Your primary care doctor will examine your medical and family history, then perform a physical exam to diagnose constipation.

Depending on the conspitation symptoms, your doctor may first try a treatment to improve the symptoms before ordering tests.

  • Medical history. Your doctor may ask you about any recent weight loss or gain or past digestive tract surgery. Your doctor may also question you about your family medical history, such as whether you have any other family members with a history of constipation problems. They will also ask about your symptoms, medications, and lifestyle.
  • Physical exam. A healthcare professional may check your abdomen for swelling, tenderness, pain, masses, or lumps during a physical exam. They may also perform a rectal exam.
  • Lab tests, including blood, stool, and urine tests.
  • Endoscopy is used to look for signs of problems in the lower digestive tract. A biopsy may be performed during these tests to look for signs of cancer. Endoscopies for constipation include colonoscopy or flexible sigmoidoscopy.
  • Colorectal transit studies. Doctors use bowel function tests called colorectal transit studies to see how stool moves through the patient’s digestive tract. One type is radiopaque markers, or an X-ray test that tracks radioactive markers while they pass through the digestive system. Another is scintigraphy, which allows the doctor to track food as it passes through the intestines.
    • Other bowel function tests may be used to look for signs of certain diseases that may be causing constipation. These include defecography, an X-ray test of the rectum; anorectal manometry, a test to check the rectum and anal sphincters; and balloon expulsion test, a test to see if the patient has problems pushing out stool.
  • Imaging tests are used to look for other problems that may be causing constipation. Imaging tests may include lower gastrointestinal series, MRIs, or CT scans.

How can a primary care doctor help?

A primary care doctor can help resolve symptoms through treatment for constipation and suggest ways to avoid it in the future. If further care is needed, your primary care doctor may refer you to a specialist.

How is Constipation Treated?

Treatment

Some people can solve constipation by making lifestyle changes and using over-the-counter medications. If constipation symptoms do not improve by self-care, your doctor may prescribe medication or suggest biofeedback training or surgery for constipation treatment.

Lifestyle changes

A healthy lifestyle is based on:

  • A healthy diet that includes foods rich in fiber, such as fruits and vegetables, whole grain bread and cereals, and beans
  • Staying hydrated by drinking plenty of water
  • Being physically active and exercising regularly
  • Keeping a regular schedule that allows time for bowel movements

Over-the-counter medication

Laxatives are substances that loosen stools, increase bowel movements, and treat and prevent constipation. The following laxatives are available over-the-counter as constipation treatments:

  • Fiber supplements add volume to stools, making them softer and easier to pass
  • Osmotic laxatives help stool move through the colon by removing fluid from the intestine, which helps stimulate bowel movements.
  • Stimulants cause the intestines to contract
  • Lubricants such as mineral oil allow stool to move through the colon more easily
  • Stool softeners moisten the stool by drawing water from the intestines
  • Enemas and suppositories. Tap water enemas with or without soapsuds can be useful to soften stool and produce a bowel movement. Glycerin or bisacodyl suppositories also aid in moving stool out of the body by providing lubrication and stimulation.

Prescription medications

A doctor may prescribe conspitation medications if other treatments don’t work. They include:

  • Medications that draw fluid to intestines. Lubiprostone, linaclotide, and plecanatide work by increasing the amount of fluid within intestines and making the passage of stool easier.
  • Serotonin 5-hydroxytryptamine 4 receptors
  • Peripherally acting mu-opioid receptor antagonists (PAMORAs) help constipation that is caused by opioid pain medications

Biofeedback training

Biofeedback training is a process used to help someone learn how to manage physical and mental health issues such as anxiety or stress, and it can be helpful for managing constipation. In biofeedback training, a therapist helps a patient learn to control the pelvis muscles using certain devices. Relaxing the pelvic floor muscles during defecation can help pass stool more easily.

Surgery

Surgery may be an option for people who have chronic constipation that is caused by a blockage in the colon or rectum. Surgical removal of part of the colon can help patients who have tried other treatments without success.

FAQs

FAQs

Constipation is common among all ages and populations in the United States. About 16% of all adults, and about 33% of people ages 60 and older, have symptoms of constipation.

Changing your diet by adding fiber, exercising regularly, and drinking enough water can help prevent constipation. When you experience constipation, over-the-counter laxatives can also help. Seek the help of a primary care doctor if the symptoms are severe and laxatives don’t help.

Not having bowel movement in three days or more is considered constipation. But constipation can last for days and weeks. You should see your doctor if your constipation lasts longer than three weeks.

You may start to feel constipated as early as the second or third month of pregnancy.

Having abdominal discomfort or pain is a common symptom of constipation.

Eating excessive amounts of certain foods can cause constipation. These include white bread and rice, red meat, dairy products, and processed and fast food.

Eating excessive amounts of certain foods can cause constipation. These include white bread and rice, red meat, dairy products, and processed and fast food.

Get Care

Receive Treatment for Constipation at NewYorkPresbyterian

At NewYork-Presbyterian, we are experienced in caring for a diverse population of patients, and we offer services for adults, children, adolescents, and older patients of all backgrounds. Our primary care services of family medicine doctors, internists, and pediatricians are available at more than 15 practices throughout Manhattan.

Same-day appointments can be made for urgent needs, and we offer early, late, and weekend hours. We accept most insurance plans. Learn more about our primary care locations and contact us to make an appointment or schedule a virtual visit.