Background: Constipation is a common condition about which there are many widespread notions that have no basis in fact. The purpose of this article is to summarize current scientific knowledge on the subject.
Methods: Selective review of the literature.
Results: Diagnostic evaluation usually fails to reveal the cause of constipation. It is due to medications in some patients, while endocrine disorders are the cause in only a small minority. Abnormal defecation may be due to dysfunction of the pelvic floor. Most patients complain of abdominal fullness and of needing to strain to pass stool; low stool frequency is a rare symptom. The symptoms alone determine the indication for treatment. Constipation usually poses no threat to health. Some patients are helped by a diet rich in fiber, others by laxatives. A number of laxatives with different modes of action are available; all are safe and generally well tolerated. In some patients, dysfunctional defecation may be an indication for proctological surgery.
Conclusions: The Rome criteria are useful for establishing a specific diagnosis of constipation. Most patients can be helped with laxatives and patient education.
Keywords: constipation; defecation; dietary fiber; laxatives.