Hello Thank you for trusting HCM Dear you have to be evaluated for constipation like 1.Blood tests:Your doctor will look for a systemic condition such as low thyroid (hypothyroidism). Examination of the rectum and lower, or sigmoid, colon (sigmoidoscopy). In this procedure, your doctor inserts a lighted, flexible tube into your anus to examine your rectum and the lower portion of your colon. 2.Examination of the rectum and entire colon (colonoscopy): This diagnostic procedure allows your doctor to examine the entire colon with a flexible, camera-equipped tube. 3.Evaluation of anal sphincter muscle function (anorectal manometry): In this procedure, your doctor inserts a narrow, flexible tube into your anus and rectum and then inflates a small balloon at the tip of the tube. The device is then pulled back through the sphincter muscle. This procedure allows your doctor to measure the coordination of the muscles you use to move your bowels. Evaluation of anal sphincter muscle speed (balloon expulsion test). Often used along with anorectal manometry, this test measures the amount of time it takes for you to push out a balloon that has been filled with water and placed in your rectum. Evaluation of how well food moves through the colon (colonic transit study). In this procedure, you may swallow a capsule that contains either a radiopaque marker or a wireless recording device. The progress of the capsule through your colon will be recorded over several days and be visible on X-rays. 4 . ray of your bowel during defecation 5. MRI defecography is useful to diagnose where is the problem. For treatment purposes you told you already used all medicine any way along with high fiber diet with daily exercise avoid alcohol and smoking. Use tab. Linaclotide or tab. Lubiprostone these medications draw water into feces but after taking tablets you have drink much amount of water. Tab. Dulcolax 2tab at night, or syrp Duphalac 30ml at night time. If symptoms not improved consult your doctor he will examine and treat you accordingly.