The purpose of this review article is to outline the main factors underlying adult chronic idiopathic constipation (colic substrates, bacterial fermentation, colic peristalsis, perineal anomalies and psychological factors) as well as readily available exploratory methods (colic transit time, anorectal manometry). A review is made of the various therapeutic possibilities, taking into account hygienico-dietetic and pharmacological treatments (mono- or multifactorial laxatives), biofeedback and psychological approaches. The main cases seen in clinical practice are described.