What Is Chronic Idiopathic Constipation?

woman with constipation
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Chronic idiopathic constipation (CIC) is a diagnosis given to individuals who experience chronic symptoms of constipation, yet no visible cause can be identified through standard diagnostic testing. (The term idiopathic means there is no known cause.) CIC is also referred to as functional constipation. CIC is classified as a functional gastrointestinal disorder (FGD), meaning that there is a problem in the way that the digestive system is functioning.

It is estimated that approximately 14% of the population experiences chronic constipation. Women, older individuals of all ages, and those with a lower socioeconomic status are at higher risk.

Symptoms of CIC

The symptoms of CIC include:

Many people who have CIC also report experiencing the following symptoms alongside the constipation:

Diagnosis of CIC

If you suspect that you have CIC, your doctor will most likely do a physical exam and run some bloodwork in order to rule out other illnesses. Other tests may be recommended depending on your symptoms and medical history.

FGS are diagnosed according to the Rome III criteria. The Rome criteria refer to the disorder as functional constipation. For a diagnosis of functional constipation, there must be no sign of abnormality evidenced through the diagnostic workup.

The criteria  state that constipation must occur with at least two of the following:

  • Fewer than three bowel movements a week
  • Straining, at least for 25% of bowel movements
  • Lumpy or hard stools in at least 25% of bowel movements
  • Feeling of incomplete evacuation following at least 25% of bowel movements
  • Sensation of blockage or obstruction during at least 25% of bowel movements

Loose stools must be a rarity without the use of laxatives and symptoms must not meet the criteria for irritable bowel syndrome (IBS). Symptoms must be present for at least three months, with onset at least six months prior to diagnosis.


By definition, CIC is only diagnosed if the criteria for IBS has not been met, which often has to do with the experience of chronic pain associated with bowel movements. However, there are indications that the two disorders are not so distinct. As stated above, many people who have a diagnosis of CIC do experience abdominal pain and discomfort. In addition, many people find themselves switching from one diagnosis to the other over time. It is possible that the two disorders actually fall upon the same continuum.

Treatment of CIC

Your doctor may discuss with you a variety of treatment options:


Bassotti, G., et. al. "Cellular and molecular basis of chronic constipation: Taking the functional/idiopathic label out" World Journal of Gastroenterology 2013 19:4099-4105.

Ford, A., et.al. "American College of Gastroenterology Monograph on the Management of Irritable Bowel Syndrome and Chronic Idiopathic Constipation" American Journal of Gastroenterology 2014 109:S2-S26.

Heidelbaugh, J. "The Spectrum of Constipation-Predominant Irritable Bowel Syndrome and Chronic Idiopathic Constipation: US Survey Assessing Symptoms, Care Seeking, and Disease Burden" American Journal of Gastroenterology 2015 110:580-587.

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