Chronic Constipation Guide

What it is

Chronic constipation is infrequent or difficult bowel movements with associated symptom burden over time.

First-line strategy

• Fiber optimization and hydration
• Osmotic or stimulant laxative protocol titration

Escalation strategy

• Evaluate alarm features and secondary causes
• Consider secretagogues or prokinetic pathways if first-line therapy fails

Non-pharmacologic care

• Daily bowel routine timing
• Physical activity support
• Pelvic floor dysfunction evaluation when indicated

Monitoring and follow-up

• Stool frequency/consistency, straining burden, quality-of-life impact, and adverse effects

Guideline references

• American College of Gastroenterology / American Gastroenterological Association constipation guidance