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Fecal straining Assessment Questionnaire

Questions Your Doctor May Ask - and Why!

During a consultation, your doctor will use various techniques to assess the symptom: Fecal straining. These will include a physical examination and possibly diagnostic tests. (Note: A physical exam is always done, diagnostic tests may or may not be performed depending on the suspected condition) Your doctor will ask several questions when assessing your condition. It is important to openly share any pertinent information to help your doctor make an accurate diagnosis.

It is also very important to bring an up-to-date list of all of your all medical conditions, medications including dosages, and names of numbers of any specialist you see.

Create your printable checklist by answering questions that your doctor may ask below:

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  1. What is the nature of fecal straining?

    Why: e.g. fecal straining during a bowel movement may be associated with either constipation or diarrhea.

  2. When did the fecal straining start?

    Why: to determine if acute or chronic e.g. if acute and associated with constipation may suggest intestinal obstruction or bowel cancer. If chronic fecal straining associated with constipation need to investigate the dietary history, emotional status and toilet habits. If acute and associated with diarrhea is likely to be infectious in nature e.g. staphylococcal toxin food poisoning, giardiasis, traveler's diarrhea, a virus or contaminated food.

  3. Frequency and consistency of bowel movements?

    Why: to establish if true constipation (i.e. less than 3 stools per week or stools that are hard to evacuate) or true diarrhea (more than 3 per day or loose or watery consistency).

  4. Dietary history?

    Why: to determine if lack of fiber may be the cause of constipation and thus fecal straining e.g. fast food is usually devoid of fiber; weight loss diets may be low in fiber; lack of dietary fiber such as fruit, vegetables and wholemeal products.

  5. Toilet habits over the life span?

    Why: e.g. a common cause of chronic constipation is the habitual neglect of the impulse to defecate leading to accumulation of large, dry faecal masses which causes constant rectal distension from feces and consequent reduced awareness of rectal fullness.

  6. If diarrhea is acute, where did you eat in the 24 hours before the diarrhea started and what food have you eaten during this time?

    Why: may help in discovering the source of possible food poisoning.

  7. Have any other family members experienced acute diarrhea also?

    Why: may suggest toxic staphylococcal gastroenteritis, Salmonella, Shigella, Campylobacter pylori.

  8. Has there been recent foreign travel?

    Why: may suggest traveler's diarrhea, cholera, shigellosis, salmonellosis and giardiasis.

  9. Past medical history?

    Why: e.g. certain conditions may predispose to constipation including depression, hypothyroidism, hypocalcaemia, diabetes, phaeochromocytoma, porphyria, hypokalaemia; certain conditions may predispose to diarrhea including hyperthyroidism, celiac disease, Addison's disease, Crohn's disease, ulcerative colitis.

  10. Past history of neurological conditions?

    Why: e.g. aganglionosis, Hirschsprung's disease, autonomic neuropathy, spinal cord injury, multiple sclerosis - may predispose to constipation.

  11. Past obstetric history?

    Why: e.g. difficult prolonged vaginal deliveries - damage to the pelvic floor muscles or nerves may cause constipation.

  12. Medication?

    Why: e.g. constipation can arise from ingestion of drugs ( such as codeine, antidepressants, aluminium or calcium antacids, antispasmotics for ulcer or urinary incontinence); the chronic use of laxatives can also lead to lazy constipated bowel; recent antibiotics may predispose to pseudomembranous colitis and diarrhea; medications that can cause diarrhea include digitalis, diuretics, beta-blockers, aspirin, colchicines, other non-steroidal anti-inflammatory medications; overuse of laxative may also cause diarrhea.

  13. Tenesmus ( painful straining with the feeling of incomplete evacuation)?

    Why: may indicate irritable bowel syndrome, rectal tumor or proctitis (inflammation of the rectum).

  14. Bloody stool with painful evacuation?

    Why: if constipated may suggest hemorrhoids or anal fissure. If defecation is painful it may cause you to delay moving your bowels due to fear of the pain which may further perpetuate the problem.

  15. Bloody stool with painless evacuation?

    Why: If constipated, may suggest colon cancer or diverticulitis. If acute bloody diarrhea, may suggest Salmonella, Shigella, Campylobacter jejuni, ulcerative colitis and amebic dysentery. If chronic bloody diarrhea, may suggest ulcerative colitis, bowel cancer, diverticulitis, amoebiasis, Zollinger-Ellison syndrome.

  16. Blood and mucous in the stool?

    Why: may suggest inflammatory bowel disease which may be associated with either constipation or diarrhea.

  17. Fever?

    Why: With diarrhea, may suggest Salmonella, Shigella, Campylobacter jejuni and ulcerative colitis, severe amoebic dysentery or pseudomembranous colitis. May get a low grade temperature with traveler's diarrhea and toxic staphylococcal gastroenteritis.

  18. Severe vomiting?

    Why: With diarrhea, may suggest toxic staphylococcal gastroenteritis (which follows 2-4 hours after eating food poisoned with the toxin), traveler's diarrhea and viral gastroenteritis.

  19. Symptoms of intestinal obstruction?

    Why: e.g. abdominal pain, vomiting, loud bowel sounds.

  20. Symptoms of irritable bowel syndrome?

    Why: e.g. passage of pellet-like stools, alternating constipation and diarrhea, associated with abdominal pain which is relieved by defecation, passage of mucous per rectum, feeling of incomplete emptying of the rectum after defection (tenesmus) and visible abdominal distention.

  21. Symptoms of bowel cancer?

    Why: e.g. may also have alternating constipation and diarrhea, rectal bleeding or bloody stool.

  22. Urinary retention?

    Why: suggest neurological conditions.

  23. Pregnant?

    Why: constipation with fecal straining is a common problem in pregnancy.

Conditions listing medical symptoms: Fecal straining:

The following list of conditions have 'Fecal straining' or similar listed as a symptom in our database. This computer-generated list may be inaccurate or incomplete. Always seek prompt professional medical advice about the cause of any symptom.

Select from the following alphabetical view of conditions which include a symptom of Fecal straining or choose View All.

 

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