Constipation physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]

Overview[edit | edit source]

Physical examination of patients with constipation is usually remarkable for anal fissure or palpable lumpy mass in abdomen (particularly in left quadrant). The presence of thrombosed external hemorrhoids, skin tags, rectal prolapse, anal fissure, anal warts, excoriation or evidence of pruritus ani due to fecal soiling on physical examination are suggestive of constipation. Patients with chronic constipation usually appear to be discomfort while sitting due to anal pain.

Physical Examination[edit | edit source]

• Physical examination of patients with constipation is usually remarkable for anal fissure or palpable lumpy mass in abdomen (particularly in left quadrant).
• The presence of thrombosed external hemorrhoids, skin tags, rectal prolapse, anal fissure, anal warts, excoriation or evidence of pruritus ani due to fecal soiling on physical examination are suggestive of constipation.^[1]

Appearance of the Patient[edit | edit source]

• Patients with chronic constipation usually appear to be discomfort while sitting due to anal pain

Skin[edit | edit source]

• Dry skin may be seen in systemic sclerosis

HEENT[edit | edit source]

• Extra-ocular movements may be abnormal

Neck[edit | edit source]

• Thyromegaly/thyroid nodules may be seen in hypothyroidism

Abdomen[edit | edit source]

• Abdominal distention
• Abdominal tenderness in the left lower abdominal quadrant
• A palpable abdominal mass in the left lower abdominal quadrant

Neuromuscular[edit | edit source]

• Altered mental status
• Clonus may be present
• Hyperreflexia
• Positive (abnormal) Babinski
• Muscle rigidity
• Abnormal gait (Parkinsonian gait)
• Unilateral/bilateral tremor (pill-rolling)

Digital rectal examination (DRE)[edit | edit source]

Method and findings of digital rectal examination include:^[2]

References[edit | edit source]

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