Pathophysiology, diagnosis and current management of chronic constipation.

Chronic constipation is prevalent in Western countries and is a complaint that is commonly seen in clinical practice. Only a relatively small percentage of constipated patients seek medical evaluation and most can be managed satisfactorily with first-line, conservative therapy. In patients with severe, refractory constipation, additional studies of colonic and anorectal function have clinical utility, as such patients are candidates for therapies not given to most constipated patients. This article reviews the modern principles and therapies used to manage chronic constipation of varying severities.