Diagnosis and management of chronic constipation in adults

Constipation is common, impairs quality of life and consumes considerable health-care resourcesRecognition of whether constipation is primary or secondary is key for appropriate managementA detailed history and physical examination including digital rectal examination is important and can identify an evacuation disorderPhysiological tests such as colonic transit assessment, anorectal manometry and the balloon expulsion test can facilitate stratification of patients with different constipation subtypesNewer drugs, such as linaclotide and lubiprostone, laxatives, and biofeedback therapy can considerably improve symptoms in patients with chronic constipation