Constipation and anal pain

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

Diseases	History and Symptoms								Physical Examination				Laboratory Findings			Other Findings	Diagnostic study of choice
													Electrolyts [Ca, K, Mg]	Biochemical tests
	GI symptoms				Extra GI symptoms				Abnormal gait	Anal protruding mass	DRE	Deep tendon reflex		FBS	TSH
	Dysphagia	Abdominal pain	Anal pain	Rectal bleeding	Weight loss	Polyphagia, Polyuria, Polydipsia	Dry skin	Tremor
Malignancy	-	-	+/-	+	++	-	-	-	-	-	Empty rectum	Normal	Normal	Normal	Normal	Acute change in bowel habits Rectal bleeding Anemia	Rectosigmoidoscopy with biopsy
Irritable bowel syndrome (IBS)	-	+	+/-	-	-	-	-	-	-	-	Normal	Normal	Normal	Normal	Normal	Frequent change in bowel habit Abdominal pain alleviating with bowel movement	Rolling out other pathophysiologies
Anal fissure	-	-	+++	+	-	-	-	-	-	-	Increased sphincter tone	Normal	Normal	Normal	Normal	Rectal bleeding after defecation Painful DRE	DRE
Anismus	-	-	+	-	-	-	-	-	-	-	Increased sphincter tone	Normal	Normal	Normal	Normal	Absence of defecation and gas passing	DRE