It's always better to get a basic lab investigations done and if abnormal definitely endo and colon Constipation r of various types and it needs to be diagnosed properly before it gets treated, because all the drug don't act in the same manner Given she is a female and high chances of pelvic floor dysnerygia she might even require a anorectal manometry

Chronic constipation with bloating at her age is most often functional (IBS-C or slow-transit constipation), commonly related to diet, hydration, gut motility, or pelvic floor dysfunction. Evaluation should include thyroid profile, glucose, and stool habits review. Endoscopy or colonoscopy is reserved for alarm features like weight loss, bleeding, anemia, or cancer history