Which tests should be done when I’m constipated?
If you noticed some of the alarming signs, you need to have a colonoscopy.
If you don’t have any alarming symptoms, you don’t need additional tests, just therapy.
The American Gastroenterological Society in its guidelines recommends that in case of constipation you take therapy. Only if therapy does not work should you run tests to see if you may have fecal incontinence or a slow transit through the colon.
When to suspect fecal incontinence?
- if you sit on the toilet for a long time
- if you have to strain hard to get the stool out
- if you have difficulty emptying your bowels even when it is soft
- if you have to use your fingers to get the stool out
What test should you do when you suspect fecal incontinence?
Anal manometry is a test to determine if you have fecal incontinence. A probe is inserted into the anus to measure how the anal sphincter works. When urinating, the colon sphincter relaxes so that the stool can come out. Fecal incontinence occurs if the sphincter contracts instead of relaxing. In addition to checking the function of the sphincter, the time required for the probe to be expelled from the rectum is also measured. If after three minutes you cannot eject the probe, you have fecal incontinence.
How to detect slow transit through the colon?
Transit time – the time required for the contents to pass through the colon
Measuring transit time in the colon is a simple test. Drink one capsule containing plastic rings marked with barium to be seen on an X-ray. After five days, take an X-ray of the abdomen while standing. If after five days on the abdominal X-ray more than 5 rings are left in the colon – it is a slow transit time.
Image – X-ray of the abdomen five days after taking the capsule