Constipation is a common problem and is frequently taken for granted by both the lay and medical populations. Although sometimes easily resolved it can prove to be a lifelong, debilitating problem, both medically and sociologically. Most frustrating is the category of idiopathic chronic constipation, a problem without identifiable etiology and diagnosed by exclusion. This paper takes an in-depth view of chronic and more specifically, idiopathic chronic constipation, discussing etiology, diagnosis and treatment. Two case histories are presented illustrating opposite ends of the spectrum in terms of severity. The objective of this paper is to enhance the reader's knowledge about a “common” problem and to increase the future appreciation for patients experiencing this alteration in bowel functioning.