Which investigations you and your doctor decide on will depend on your symptoms, family history and age.

Medical history - The doctor may ask you to describe your constipation, particularly how long you have been constipated, how often your bowel movements are, consistency of stools, presence of blood and your bowel habits. A record of eating habits, medication, and level of physical activity or exercise will also help the doctor determine the cause of constipation.

Physical examination - This may include a digital rectal examination, where a gloved, lubricated finger is used to evaluate the tone of the anal sphincter and also detect tenderness, obstruction and blood. In some cases, blood and thyroid tests might be necessary to look for thyroid disease and serum calcium, OR to rule out inflammatory, endocrine, metabolic and other systemic disorders which may be causing your constipation.

Special investigations - These are usually reserved for people with severe symptoms, for those with sudden changes in number and consistency of bowel movements or blood in the stool and for older adults. These specialised tests involve colonic investigations to look for anatomical causes of symptoms (endoscopy, barium enema X-ray), anorectal physiological testing (anorectal manometry, balloon expulsion test, electromyography), colorectal transit studies and defaecating proctography.

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