Many of us have experienced having a difficult bowel movement before in our lives. Imagine having that chronically. Well, that is the case with up to 80% of the world's population. Chronic constipation is a common digestive problem impacting many people's lives. However, with a focus on discovering the underlying causes combined with a comprehensive care approach, this chronic condition can be effectively treated and managed. That's precisely how regular testing using functional medicine labs can help. Clinicians often use these specialty labs to uncover the root cause or causes of disease to help their patients improve their quality of life and overall health. 

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What is Constipation?

Constipation is a digestive tract condition that affects bowel movements. It can make it difficult to pass a stool or cause people to have infrequent stools or a mix of both for people with constipation. The troublesome bowel movements may also accompany pain and stiffness. From a medical perspective, characteristics of constipation also include dry and hard stool, not having a bowel movement more than three times per week, and not having a complete bowel movement. It's significant to mention that there is no ideal definition for constipation, making history and a physical exam essential in the diagnostic process.

What Are The Common Causes and Challenges of Chronic Constipation?

The challenge with chronic constipation is that the primary cause is considered an idiopathic (unknown) condition, and there is no ideal definition currently. Most of the definitions are interpreted using self-reported criteria.

However, medically, the pathogenesis of chronic constipation is multifactorial and from secondary causes such as digestive mobility, endocrine imbalances, pelvic floor dysfunction, autoimmunity, disorders of the nervous system, medications, and other gastrointestinal (GI) disorders like IBS. There are also lifestyle and environmental factors that are linked with chronic constipation. These influences include a lack of exercise or movement, food sensitivities, diet, and water intake. A genetic predisposition also increases the risk of this condition.

What is The Role of Lab Tests in Diagnosing Chronic Constipation?

The role of lab testing is to deter more severe issues from occurring, such as acute constipation that may block the intestine and require surgery. Prevention measures can be implemented by identifying the causes and the risk factors through testing. Labs also play a crucial role in pinpointing the many secondary causes to help guide interventions to improve symptoms and to help resolve constipation for patients. Retesting will provide insights into how well the treatments are working so proper adjustments can be made to improve the health outcomes for those suffering from chronic constipation.

Top Labs for Bi-Annual Testing in Chronic Constipation Patients

These are the top labs that should be considered for patients with chronic constipation:

Comprehensive Blood Tests for Chronic Constipation Patients

Examining a complete blood count (CBC) and comprehensive metabolic panel (CMP) can offer valuable information about nutritional deficiencies, inflammation, and electrolyte imbalances when testing for constipation. A CBC can assess for conditions such as anemia involving iron or B12 deficiency and general overall health status, including inflammation. At the same time, CMP can provide information on electrolyte imbalances, such as hypokalemia or hypercalcemia, associated with constipation. These labs can provide a baseline for clinicians as abnormal levels can indicate possible secondary causes that can contribute to chronic constipation, providing guidance on further exploration.

Hormonal and Thyroid Function Tests

Understanding the significance of thyroid levels, such as TSH, and other hormones, such as sex hormones and insulin, is crucial for assessing constipation. A thyroid panel can measure thyroid hormones, and a comprehensive hormone test can determine levels of sex hormones. Fluctuations of sex hormones may cause constipation. Elevated levels of TSH indicate hypothyroidism, which can slow the motility of the digestive tract causing constipation. A diabetes panel can measure insulin imbalances linked to diabetes. Diabetes can disrupt brain and gut signals resulting in constipation. The results of these labs can influence treatment strategies and prevention protocols for chronic constipation.

Evaluating Gut Health: Microbiome Analysis

A thorough microbiome analysis is crucial for digestive health. The microbiome plays a primary role in gut health, and imbalances can lead to GI issues such as constipation. An imbalanced microbiome can lead to GI conditions such as IBS or IBD, in which constipation is a primary symptom of those chronic conditions. The GI Effects Comprehensive Profile provides microbiome sequencing that assesses overall gut health and microbiome function. This test analyzes markers such as fecal calprotectin indicated in GI conditions such as IBS and IBD. The results of this test can provide an in-depth look into gut function and guide personalized treatment recommendations to address any imbalances that can contribute to constipation.

Screening for Celiac Disease and Gluten Sensitivity

Both Celiac Disease and gluten sensitivity have been linked with chronic constipation. These chronic conditions are triggered by consuming wheat gliadin or proteins of wheat that cause digestive issues for these patients. Celiac and gluten sensitivity screening can be performed from one test, the Celiac Panel. This specialty test includes total IgA, IgA, and IgG antibodies to tTG, endomysial, and deamidated gliadin peptide; and HLA DQ2 and DQ8, all of which are markers for Celiac or gluten sensitivity. This test can provide some insights into constipation for people who may be reactive to gluten or wheat.

Assessing Inflammatory Markers

Chronic constipation highlights the significance of testing C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) in constipation evaluation. Elevated inflammatory markers suggest potential underlying gastrointestinal inflammation often present in digestive disorders such as IBS and IBD. Regular testing of these inflammatory markers can help monitor improvements in those inflammatory conditions and if any other interventions need to be made.

Exploring Food Allergies and Intolerances

Food allergies and intolerances have been shown to contribute to constipation. Therefore, investigating these food reactions through an IgE and IgG food test can be helpful for chronic constipation assessment and management. This complete food reaction test can pinpoint the possible dietary triggers that could exacerbate constipation symptoms, enabling providers to create a personalized nutritional protocol to improve constipation related to any food allergies or intolerances.

Genetic Testing for Chronic Constipation Risk Factors

The CICA Genetics test examines genetic indicators linked to Celiac disease and Crohn's disease, aiding in identifying a patient's genetic susceptibility to these conditions as these conditions are associated with constipation. Knowing if your patients are genetically susceptible to these conditions can enable you to create preventative treatment plans to reduce these conditions' risks and associated symptoms, such as constipation.

Additional Labs to Check 

You may also run these other labs and tests on your patients to assess constipation. These tests include procedures like endoscopy, colonoscopy, and sigmoidoscopy, which provide internal views of the gastrointestinal tract. Further assessments involve defecography for stool expulsion observation, lower GI series using barium for enhanced colon imaging, and advanced techniques like magnetic resonance imaging (MRI) and computed tomography (CT).

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Summary

With a high prevalence of chronic constipation impacting the general population, it's vital that there are diagnostic and therapeutic options that address this. Being attentive to the underlying factors, often due to secondary causes of constipation, can help us better understand its pathophysiology. This understanding can facilitate clinicians in managing this issue more effectively. Functional labs are a powerful resource to help you and your patients resolve the symptoms associated with chronic constipation by identifying the factors that cause it.