An article published in Clinical Interventions in Aging reported that constipation a common functional gastrointestinal disorder has a prevalence of approximately 20 in the general population. However in the elderly the incidence is higher in comparison with higher predisposition to severe constipation among elderly females. It was stated that understanding the underlying etiology of chronic constipation CC is essential to determine the most appropriate therapeutic option. Thus it is important to distinguish between pelvic floor dysfunction PFD slow and normal transit constipation. The article elaborated on the evaluation of CC which includes basic blood work rectal examination and appropriate testing to evaluate for PFD and slow transit constipation when indicated. It was suggested that pelvic floor rehabilitation or biofeedback is the treatment of choice for PFD. Surgery is rarely indicated in CC and can only be considered in cases of slow transit constipation when PFD has been properly excluded. Other treatment options such as sacral nerve stimulation in patients with urinary dysfunction were also discussed. In summary it was acknowledged that it is crucial to identify the etiology of CC and hence treatment should be based on the patient s overall clinical status and capabilities especially in geriatric patients.1 Reference 1. Vazquez Roque M Bouras EP. Epidemiology and management of chronic constipation in elderly patients. Clinical Interventions in Aging. 2015 10 919 930. doi 10.2147 CIA.S54304.