Assessing constipation

Before you have treatment for constipation, your doctor or nurse will need to find out how bad it is, and what the cause could be.

Talking about constipation

Some people find it difficult to talk about constipation. You might feel embarrassed or upset about it. Or you might worry about what the cause is. It’s completely natural to feel like this. Remember that your doctor or nurse can suggest ways to treat and relieve constipation. Don’t be afraid to ask for their help, they are used to talking about these things.

It might help to write down any problems and give a note to your doctor or nurse to read if you find it difficult to talk to them. It can also help to have a friend or relative go along with you and do the talking.

If your treatment is in an open day unit, you can ask to go into a private room to discuss your bowel problems. Your doctor or nurse will understand if you want to speak to them in private, and they will want to help you. So do ask any questions you have. 

What your doctor or nurse will do

Before your doctor or nurse can treat your constipation, they need to find out how bad it is and what is causing it. It is important to assess all aspects of your constipation so that you get the right treatment. 

You are usually first asked questions about the constipation and your bowel habits.

Your doctor or nurse also might:

• examine you
• take some measurements such as your blood pressure, heart rate and temperature
• give you laxatives
• suggest other ways of managing your constipation, for example, advice on increasing your physical activity and what to eat and drink
• arrange some tests and investigations

Physical examination

Your doctor or nurse might feel your tummy (abdomen). You might also have an examination of your back passage (rectum) and back passage opening (anus).

An examination of the rectum is also called a digital rectal examination (DRE). It involves your doctor or nurse feeling inside your anus and rectum using their gloved finger. They use lubricant  so it’s more comfortable for you.

It’s normal to feel anxious about this test, but it usually only takes less than a minute. You can ask for someone else to be in the room if you want, to act as a chaperone. A chaperone is a trained health professional such as a nurse. A friend or relative can also stay with you for support. They can be with you during the examination or throughout the appointment.

We have more information about having an examination of your rectum and what happens. The information is based on people having this test for cancer. However, it can give you a feel of what to expect during the examination if you see your doctor or nurse about constipation.

Questions your doctor or nurse may ask

Knowing the answer to these questions can help build up a picture of what might be causing your constipation. The doctor or nurse can then plan the best treatment to manage it.

• When did you last open your bowels?

• What does your poo look like?

• Is the poo very hard?

• What are your normal bowel habits?

• What other symptoms do you have: for example, do you feel sick, or have a swollen tummy?

• What kind of foods do you eat?

• Have you made any changes to your diet?

• How much exercise do you get?

• How much liquid do you drink each day?

• What kind of drinks do you have?

• Do you get constipated soon after you have had your cancer treatment?

• When did you last have your cancer treatment?

• Are you taking any other medicines?

• Are you taking any medicines to help with your constipation?

A family member or close friend could help answer questions if you are feeling too uncomfortable or tired. Or if you really don't feel able to speak to the doctor or nurse about it.