[Constipation].

Constipation may be due to drug intake, metabolic and endocrine abnormalities, neurogenic diseases, and gastro-intestinal lesions: in these cases, constipation is only the consequence of another disease. Constipation may be due to dietary or behavioural errors in a lot of patients: in these cases constipation is the consequence of the way of life of the patients. When these two first types of constipation have been ruled out, the constipation is a true constipation, described as chronic idiopathic constipation for which no organic cause may be found. This chronic constipation may be due to a delayed colonic transit secondary either to a colonic inertia in few cases or, at the opposite, to an increased colonic motility in a lot of people often associated with abdominal pain. Chronic constipation may be also due to an outlet obstruction, secondary to a megarectum, a megarecto-sigmoïd, a rectocele, or an abnormal anorectal motility (mainly anismus, often associated with sexual abuse in the past history). No single mechanism can be held responsible for chronic idiopathic constipation, but, whatever the mechanism and the type, constipation is also frequently a way to get help from the doctor.