ABSTRACT
Despite its common nature, constipation can be one of the most difficult problems to manage; this is reflected in a relatively high failure rate both with medical and with surgical treatment (1). Many factors contribute to this challenge. First, definitions vary among patients and professionals, which partly explains the tremendous differences among epidemiological studies and clinical trials (2). Second, constipation has a multifactorial and complex etiology, including not only anatomical and functional, but also dietary, psychological, and cultural factors. Third, this symptom is still surrounded by misconceptions and taboos, which hamper an objective evaluation and determine self-medication, not always innocuous to the patient. Finally, the patient may either be labeled as having a psychiatric disorder or undergo more aggressive medicamentous therapy by the physician without previous physiologic investigation.
