Chronic Constipation

Consider functional bowel disease

Clinical and basic laboratory tests
Bloods, chest and abd x-ray
Exclude mechanical obstruction, e.g., colonoscopy

Colonic transit

Abnormal

Normal

End

Rx

Slow colonic transit

Known disorder

No known underlying disorder

Appropriate Rx: Rehabilitation program, surgery, or other

Anorectal manometry and balloon expulsion

Normal

Rectoanal angle measurement, defecation proctography?