CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.
Constipation - Making a diagnosis
How do I know my patient has constipation?
- Constipation is diagnosed in adults when defecation is unsatisfactory because of infrequent stools, difficult stool passage, or seemingly incomplete defecation. If a person continues to complain about constipation after a discussion of what is normal and what is abnormal (especially with respect to frequency), they are asking for help in managing their problem, and should be regarded as having (symptoms of) constipation.
- Functional constipation is diagnosed by excluding the drug and medical causes of secondary constipation.
- Faecal loading/impaction is diagnosed:
- On history. The person reports:
- Passing hard, lumpy stools, either large and infrequent (e.g. every 7–10 days), or small and relatively frequent (e.g. every 2 or 3 days).
- Having to use manual methods to extract faeces.
- Overflow faecal incontinence, or loose stool.
- On examination:
- Faecal masses are palpable abdominally or peri-anally, or on internal rectal examination.
© NHS Institute for Innovation and Improvement