How Do We Diagnose Chronic Constipation?

Stanford Health Care’s comprehensive diagnostic approach includes examining your nerves, muscle control, and diet. Working together, our nutritionists and gastrointestinal motility experts conduct advanced testing both within and outside of our dedicated Gastrointestinal Motility Lab. Our goal is to rule out possible underlying conditions, such as pelvic floor dyssynergia, so we can determine the best course of treatment.

We may perform one or more of the following tests:

• Abdominal computed tomography (CT) scan: Using X-rays and special computer software, this test creates two- and three-dimensional images of your intestines. Providing alternative views of your bowel, pancreas, and other organs, CT scans help us examine details that might not be visible through other imaging tests.
• Abdominal X-ray: A standard X-ray of your small intestine to identify abnormalities or blockages
• Anorectal manometry: Measuring muscle strength in your anus with the help of a thin plastic probe we place in your rectum. This test also measures sensation and reflex activity.
• Barium enema/lower GI series: X-ray study of your rectum, large intestine, and the lower part of your small intestine using a special dye containing barium. This chemical helps show the fine details of your intestines. Learn more about barium enema/lower GI series.
• Blood tests: Using a sample of your blood, we may run a number of tests including:
  • Complete blood count to look for signs of anemia and infections
  • Electrolyte and kidney function panel to look for electrolyte abnormalities and liver issues
  • Albumin tests to assess your nutritional status
• Colonic transit study (Sitz marker study): This test assesses how long it takes for food to move from your stomach through a bowel movement with a series of X-rays and a capsule with tiny rings that you swallow.
• Colonoscopy or sigmoidoscopy: Examining the entire length of your colon (screening colonoscopy) or just the lower part of your colon (sigmoidoscopy) with the help of a small flexible tube and tiny camera we insert into your rectum.
• Defecating proctogram: Recording movement in your pelvic floor muscles and rectum while you attempt to empty the contents of your rectum
• Magnetic resonance imaging (MRI) defecography: Examining all structures in your pelvic floor, rectum, and sphincter, with the help of magnetic resonance imaging, which uses radio waves and a strong magnetic field
• Wireless capsule gastrointestinal monitoring system: Swallowing a pill with a tiny wireless monitoring system inside (SmartPill®) to record acid levels, temperature, and pressure changes in your GI tract. The wireless motility test lets us know how fast or slow your stomach, small bowel, and colon are emptying. Your body cannot digest the SmartPill®, and it will eventually pass through a bowel movement.