Approach to evaluation of the patient with chronic constipation

* Laboratory studies include a complete blood cell count to identify anemia, serum glucose (for diabetes mellitus), calcium (for hypercalcemia), and thyroid-stimulating hormone (for hypothyroidism).

¶ Additional evaluation including abdominal imaging may be needed based on symptoms.

Δ Refer to UpToDate topic on irritable bowel syndrome.

◊ Management based on the underlying defecatory disorder (eg, rectocele, dyssynergic defecation). Refer to UpToDate topic reviews.

§ Scintigraphy is an alternative to radiopaque marker study.