Chronic constipation is a common problem in children; it is responsible for 5% of referrals to general paediatricians, 20% of referrals to paediatric gastroenterologists, and 10000 admissions to hospitals in the United Kingdom every year. Constipation is particularly common in children with disabilities; in a recent epidemiological survey of nutritional and gastrointestinal problems in children with cerebral palsy, constipation (defined as opening of the bowels less frequently than once in every 3 days) was reported in 98 of 377 (26%) of children. There is frequently a delay in the recognition and appropriate treatment of constipation in children and symptoms are often present for months or years before appropriate treatment is provided. Such delay is a particular problem in children with disabilities either because it is accepted as an inevitable consequence of the neurological impairment or because a higher priority is given to other aspects of medical management such as treatment of convulsions or postural deformity. Moreover, communication difficulties compound delay and failure to recognize the problem as the child with disabilities is often unable to express the discomfort caused by constipation. Abdominal pain is a frequently encountered symptom of chronic constipation in those children who are able to give an account of their experience and contributes considerably to the adverse effect that chronic constipation has on their quality of life. Similarly, adequate treatment of constipation provides relief for the child and can be observed to lead to an improvement in appetite or behaviour. For instance, the improvement in behaviour of children with autism following evacuation of retained faeces after constipation is frequently encountered in clinical practice.