The symptoms are

1. Hard stools.

2. Infrequent stools(fewer than three per week)

3. Need for excessive straining.

4. Sense of incomplete bowel evacuation.

5. Excessive time spent on unsuccessful evacuation.

Causes for Constipation:

1. Obstruction.

2. IBS.

3. Metabolic Hypothyroid.

4. Hypercalcemia.

5. Parkinsonism.

6. Multiple sclerosis.

7. Scleroderma.

8. Amyloidosis

9. Depression.

10. Eating disorders.

11. Anal sphincter spasm.

12. Certain drugs(anti depressants, opiates, antacids, iron)

Investigations:

1. Thyroid profile.

2. Serum calcium.

3. Sigmoidoscopy and barium enema.

4. Colonoscopy.

5. Colonic transit testing.

6. Baloon testing.

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