How Does a Doctor Diagnose CIC?
Visiting a doctor about CIC can be difficult because talking about bowel movements is not something most people find easy to do. It helps to remember, though, that physicians talk about body functions all the time: it's their job.
At a visit to the doctor to discuss constipation, expect questions about bowel movements, including how many and what they look like, as well as questions about diet and lifestyle. There may also be a physical exam, which can include a rectal exam.
Typically other tests aren't done in the diagnosis of constipation unless there are signs or symptoms involved, such as bleeding, weight loss, significant pain, or any risk factors for colon cancer. If your doctor orders additional tests, be sure to inquire and discuss the reason so that you fully understand the purpose and information the test will provide. Being an empowered patient will help you feel more confident in coping with your condition.
Digital Rectal Exam
The rectal exam is a test that comes with a fair amount of worry for many people. Although most people feel some pressure during the exam, it's over very quickly and can give the physician a lot of information. A physician will insert a gloved, lubricated finger into the rectum to check the structures there.
If constipation is suspected to be related to another condition, a doctor might order blood tests. The blood tests might help a physician to understand if it's necessary to look deeper for another problem that's related to the constipation.
Anorectal (or Rectal) Manometry
This is a specialized test that is typically only used after someone with constipation starts treatment but doesn't experience any relief from symptoms.
A small catheter is inserted into the rectum and used to take measurements on the pressure there. An enema is usually given before the test, to expel its contents, which takes about a half an hour.
This test might be ordered if a physician suspects that symptoms are being caused by a condition called dyssynergic constipation, which causes the muscles in the pelvic floor to work not as well as they should. It is not done very often.
Balloon Expulsion Test
In this test, a catheter with a balloon on the end is inserted into the anus. Either air or water is put into the balloon to inflate it. The next step is to pass the balloon, like having a bowel movement, and measurements are taken while this is happening.
An enema is usually given before the test, and passing the balloon is done in a bathroom, for privacy. This test might also be done if dyssynergic constipation is suspected. However, this test is not done very often.
Some people with constipation may be referred to a gastroenterologist for a colonoscopy. A colonoscopy is a test where a camera with a light on the end is inserted into the anus and moved through the colon to examine it from the inside. This test is common if a patient has new onset bowel changes in an age range where cancer is a possibility, or if there are warning signs (for example, occult blood).
The test itself is done under anesthesia, so patients don't feel or remember anything. To prepare, a physician will give instructions on how to clean out the colon of stool in the days leading up to the test.