clinical features

Last reviewed 10/2023

The clinical features of constipation include:

  • infrequent, incomplete evacuation of stools - generally this is taken to be less than twice a week; however, normal bowel habit is less than two bowel motions per week for some. More significant is the change in bowel habit relative to the patient's normal bowel habit.

  • anorexia and vague abdominal discomfort

  • diarrhoea - constipation may cause overflow or spurious diarrhoea, especially in the elderly, when faecal fluid intermittently escapes past an impacted faecal mass

  • acute abdominal pain - usually in children - or features of intestinal obstruction - usually in the elderly

  • on examination, there may be mild abdominal tenderness and a faecally-loaded colon on the left side. There is usually a mass of faeces felt on rectal examination. In elderly patients, faeces may be impacted higher up and so an empty rectum does not exclude constipation.