Distended colon on x ray with air fluid level on right side. severe constipation but no evidence of obstruction. concerning?

No: Severe constipation is concerning because of how uncomfortable it can be the impact it can have if uncontrolled; however the xray with no obstruction is reassuring - but this is not always a perfect test. The air fluid level can be nonspecific sign. It is important that you get on a good bowel regimen to regulate your bowel movements.

Maybe/not: Anyone with a history of chronic or severe constipation will likely show evidence their colon has dilated. This ballooning is the result of chronic stool retention & results in weakened circular muscles within the walls that help you poop effectively, which aggravates the issue. The fluid level is confusing. A bowel rehab program under the guidance of a GI doc may reverse the process.