Constipation as a disorder of heterogeneous etiology is a com­mon and often refractory clinical problem. Treatment of chronic constipation depends on the pathophysiological types that often overlap each other. Secondary constipation is brought about by many coinciding causes, so the diagnostics and therapy should be multifactorial against risk factors, dietary, behavioral and care errors. Patients with advanced, progressive illness are particularly exposed to persistent constipation, especially those taking opioid analgesics. In these patients diagnostics is more difficult and therapy usually ineffective, so the emphasis is put on prevention by keeping to appropriate diet and nursing. A novel method for prophylaxis and managing constipation in patients requiring opioid therapy is treatment with combined preparations consisting of an opioid agent and an opioid antagonist.