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

Constipation: understanding mechanisms and management.

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Department of Internal Medicine, Mayo Clinic in Arizona, Scottsdale, AZ, USA.


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.


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

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