This article defines the various types of defecatory problems which could be termed idiopathic constipation, and outlines the main diagnostic tests used to identify its origins. It highlights the limited role that laxatives, increased dietary fibre, and surgery can play in the management of this condition. It suggests the use of biofeedback and associated non-invasive strategies as the treatment of first choice in idiopathic constipation. The article stresses that as there is often a significant psychological cause or contribution to this condition, the counselling, discussion, and listening which biofeedback therapy entails are just as important as training patients to coordinate their defecatory muscles during straining. Less