Stimulant laxatives are generally reserved for when other types are not effective. Other treatments may include biofeedback or in rare cases surgery.In the general population rates of constipation are 2–30 percent. Among elderly people living in a care home the rate of constipation is 50–75 percent. People spend, in the United States, more than US$250 million on medications for constipation a year. Definition
Constipation is a symptom, not a disease. Most commonly, constipation is thought of as infrequent bowel movements, usually fewer than 3 stools per week. However, people may have other complaints as well including:
Straining with bowel movements
Excessive time needed to pass a bowel movement
Hard stools
Pain with bowel movements secondary to straining
Abdominal pain
Abdominal bloating. the sensation of incomplete bowel evacuation.The Rome III Criteria are a set of symptoms that help standardize the diagnosis of constipation in various age groups. These criteria help physicians to better define constipation in a standardized manner. Causes
The causes of constipation can be divided into congenital, primary, and secondary. The most common kind is primary and not life-threatening. It can also be divided by the age group affected such as children and adults. Primary or functional constipation is defined by ongoing symptoms for greater than six months not due to an underlying cause such as medication side effects or an underlying medical condition. It is not associated with abdominal pain, thus distinguishing it from irritable bowel syndrome. It is the most common kind of constipation, and is often multifactorial.
Tests may include CBC (complete blood count), thyroid function tests, serum calcium, serum potassium, etc.Abdominal X-rays are generally only performed if bowel obstruction is suspected, may reveal extensive impacted fecal matter in the colon, and may confirm or rule out other causes of similar symptoms.Colonoscopy may be performed if an abnormality in the colon like a tumor is suspected. Other tests rarely ordered include anorectal manometry, anal sphincter electromyography, and defecography.Colonic propagating pressure wave sequences (PSs) are responsible for discrete movements of the bowel contents and are vital for normal defecation. Deficiencies in PS frequency, amplitude, and extent of propagation are all implicated in severe defecatory dysfunction (SDD). Mechanisms that can normalize these aberrant motor patterns may help rectify the problem. Recently the novel therapy of sacral nerve stimulation (SNS) has been utilized for the treatment of severe constipation. Criteria
The Rome III Criteria for functional constipation must include two or more of the following and present for the past three months, with symptoms starting for at least 6 months prior to diagnosis. Straining during defecation for at least 25% of bowel movements
Lumpy or hard stools in at least 25% of defecations
Sensation of incomplete evacuation for at least 25% of defecations
Sensation of anorectal obstruction/blockage for at least 25% of defecations
Manual maneuvers to facilitate at least 25% of defecations
Fewer than 3 defecations per week
Loose stools are rarely present without the use of laxatives
There are insufficient criteria for irritable bowel syndrome

Prevention
Constipation is usually easier to prevent than to treat.