Constipation is variably defined, but usually refers to persistent, difficult, infrequent, or seemingly incomplete defecation. An exhaustive list of possible factors may contribute to chronic constipation. Most patients are successfully treated without elaborate, expensive diagnostic procedures, by implementing simple alterations in diet and lifestyle. In the small percentage of patients in whom this fails, a more in-depth analysis of the problem may lead to more specialized forms of therapy. Bowel retraining, or biofeedback, often serves as a foundation for further therapy, but pharmacologic aids or surgery may also be necessary. Unfortunately, results in these patients are not universally optimistic, but patient selection is the key.