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June 21, 2019

What about testing? It depends on the age of the patient and their associated symptoms. Let’s say for example, we have a young person who is in great health who’s noticed some constipation. Well, the physician would then probably do a detailed history, physical exam, ask about things such as change in diet. Are they hydrating themselves appropriately? Have they started a new medication which can contribute to constipation, etc? And then if, if the answers to those questions reveal just quote on quote garden variety constipation, we’d make some changes in their diet, etc. Perhaps give them a stool softener, encourage increased fiber in the diet, and monitor the patient. If the patient complained of chronic constipation, this is the same young individual, then we might go a step further and perhaps do a test called a sitz marker test. That’s a fancy word, but basically what the patient would do is consume some pellets. These are barium sulfate type tablets, and then they would get an x-ray, perhaps four days later. And what you would look for is to see the migration of these radio opaque markers and see if the patient were able to expel them within four days period of time. If the patient retained those pellets beyond four days, then that would be grounds to say that this person had some significant low colonic transit. Okay. It may be useful to see if the pellets collected in the rectum or if they were hung up throughout all areas of the colon. That may give you some idea as to the cause, whether it’s outlet obstruction versus general slow motility. And lastly, if the patient were older, and if the patient had some warning signs, some signs you might be concerned about, such as significant weight loss or blood per rectum, or decrease in appetite, then we would probably recommend that the patient go for a colonoscopic exam.

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