[Management of chronic constipation in primary care]

Chronic constipation is a common reason for consultation in primary care. After excluding red flags and secondary causes, three main clinical situations should be distinguished: functional constipation, irritable bowel syndrome with constipation, and defecatory disorders. These conditions differ in their pathophysiological mechanisms and require appropriate management. Management is based on a stepwise approach combining lifestyle and dietary measures, targeted pharmacological therapy, pelvic floor rehabilitation for defecatory disorders and, more rarely, surgery.