Constipation and Impaction

Diagnosis

Most people with simple constipation can diagnose and treat themselves. If you have constipation, begin by examining your lifestyle. Review your current diet, your level of daily exercise, and your bowel habits. In particular, do you often ignore the urge to have a bowel movement because it is inconvenient? Then take preventive measures, such as adding fiber to your diet, drinking plenty of fluid, and getting regular exercise. If this does not relieve your problem, contact your doctor.

If you have constipation together with rectal bleeding, abdominal pain or abdominal distention (bloating), contact your doctor immediately. It is best in this case for your doctor to evaluate you, including a physical exam and digital rectal examination.

If your symptoms indicate you might have fecal impaction, your doctor can confirm the diagnosis by examining your abdomen and by checking for a mass of impacted feces during the digital rectal exam. You may need other tests, including blood tests, plain abdominal X-rays, a barium enema or sigmoidoscopy (in which a special instrument is used to view the lower colon).

People 50 years and older are more likely to develop colon polyps or colon cancer. Constipation can be a symptom of colon polyps or cancer, and you should make sure that your screening for colon cancer (by colonoscopy or another test) is up-to-date.

Expected Duration

How long constipation lasts depends on its cause. In most otherwise healthy adults, constipation improves gradually within a few weeks after they increase their intake of dietary fiber and fluid and begin exercising regularly. However, constipation in bedridden people with neurological problems can be persistent and is a risk factor for fecal impaction.