Constipation: understanding mechanisms and management

Clin Geriatr Med. 2014 Feb;30(1):107-15. doi: 10.1016/j.cger.2013.10.001.


Constipation is a frequently diagnosed gastrointestinal disorder. Symptoms of constipation are common, with the greatest prevalence in the elderly. Evaluation of constipation begins with a detailed medical history and a focused anorectal examination. Diagnostic testing for constipation is not routinely recommended in the initial evaluation in the absence of alarm signs. Key self-management strategies include increased exercise, a high-fiber diet, and toilet training. High-fiber diets can worsen symptoms in some patients who have chronic constipation. Biofeedback is an effective treatment option for patients who have constipation caused by outlet obstruction defecation. A variety of medications are available to remedy constipation.

Keywords: Anorectal manometry; Chronic constipation; Constipation testing; Dyssynergic defecation; Outlet dysfunction; Pelvic floor dysfunction; Slow transit constipation.

Publication types

  • Review

MeSH terms

  • Age Factors
  • Biofeedback, Psychology / methods
  • Constipation* / diagnosis
  • Constipation* / epidemiology
  • Constipation* / etiology
  • Constipation* / physiopathology
  • Constipation* / psychology
  • Constipation* / therapy
  • Dietary Fiber* / deficiency
  • Dietary Fiber* / therapeutic use
  • Disease Management
  • Feeding Behavior / physiology*
  • Gastrointestinal Agents* / classification
  • Gastrointestinal Agents* / therapeutic use
  • Gastrointestinal Motility
  • Gastrointestinal Tract / pathology
  • Gastrointestinal Tract / physiopathology
  • Humans
  • Prevalence
  • Risk Factors
  • Sedentary Behavior*


  • Dietary Fiber
  • Gastrointestinal Agents