Johns Hopkins Health Alert
Diagnosing Constipation
Nearly everyone has had a bout of constipation -- infrequent bowel movements and difficulty passing stool -- at some point in their life. Constipation is not a disease, but rather a symptom that can stem from a number of medical conditions. Constipation becomes more common with age and occurs in at least 25% of people over age 65. In most cases, constipation is not a serious condition, and can be treated with lifestyle measures, such as increasing your intake of dietary fiber and level of physical activity or the short-term use of laxatives. In rare cases, surgery may be necessary to relieve symptoms of constipation.
When someone complains of chronic constipation, a gastroenterologist may perform a number of tests to identify the underlying cause of the constipation and the best way to treat it. But according to a study reported in the American Journal of Gastroenterology (Volume 100, page 1605), many of these tests are unnecessary.
To assess the value of various tests used to investigate constipation, researchers performed a search of the medical literature from 1966-2004. They found little or no evidence to support the routine use of blood tests, abdominal x-rays, sigmoidoscopies, colonoscopies, or barium enemas in people with constipation who do not have red-flag symptoms (such as rectal bleeding or unexplained weight loss).
There was, however, some evidence for the use of colonic transit tests (which measure the amount of time it takes for stool to move through the colon), anorectal manometry (which measures pressure in the rectum and anus), and balloon expulsion tests (which measure the ability of the rectum to expel feces). The researchers found that these three tests can reveal physical abnormalities that can lead to constipation. Still, no single test can identify the underlying cause of constipation in all patients, and several tests may be required to determine the exact cause of constipation and how to treat it.
Posted in Digestive Health on January 14, 2008
Reviewed September 2011
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As a child I almost died from Chronic Colitis, but I survived twice; first the Shoah and then Chronic Colitis. When medisin and food came from Sweden, I miraculoes survived, allthough the doctor hadn't given my parents much hope. It has since been a problem most of life. In my early 30ties, I had 6 big larpatomies caused by 2 Volvulus, 2 postoperative Ileus and 2 colon resections. I also had a colostomi because I got an abcess and peritonitis after the first colon resection. I have been told, that the causes for Chronic Colitis is sometimes a psychosomatic disease (PSTD), which just after WWII knew little about. But after I had all these operations, I was told the Volvoluses and later Ileus, had their cause in both PTSD and fysical very long colon. After the last colon resection, which left a very narrow space when the ends were sutured together. What has become uncomfortable, because all food 'lines up' infront of that narrow 'gate' and I have to take Stool softener and Lacxica every day. This is not a good solutions because I have no control and I feel like I have colostomi again. I know that a third colon resection might solve the problem, but now I'm so old that I have no 'taste' for going through such a big operation. Also I'm serious disabled from Chronic Fibromyaligy Syndrom, Sjogren's Syndrom and severe osteoporose. Fiber rich diet is not the solution because I have to avoid beans, lentals, red meat, diary products and fiber. In addition I had a work accident in the late 70ties, which gave me a serious nuclus prolaps and have been always treated conservativt because an operation might stiffen my spinal cord. However, now both the cervix and lumbal part are pretty crocked. I have resigned to live with these 'ailments', but it's not easy. As a result, I can't plan anything because when 'time' comes I can't leave our home, and I sometimes miss Shul on Shabbat which I love to attend.
Posted by: heksa | January 23, 2010 1:52 PM