便祕在一般門診是最令病人與醫師頭大的疾患，希望能藉由此文章讓醫師端能更加瞭解便祕之初步臨床診斷思路；如何逐步幫病患找到便祕之病因，排除較嚴重之疾患，確立慢性特發性便祕之診斷；如何在臨床由基本病史詢問，焦點式理學檢查，相關之生化，影像內視鏡檢查等而確立便祕之正確診斷。本文因篇幅分為上下篇，上篇主要描述正常生理，定義，風險因子與病理機轉；下篇主要描述相關病史，理學檢查與進階檢查。希望能藉由此文章幫助病患更正確的處理看似小但其實每天都會困擾人的問題。

Chronic idiopathic constipation is one of the most common and challenging conditions encountered in general outpatient clinics, both for patients and physicians. This article aims to provide physicians with a better understanding of the initial clinical diagnostic approach to constipation: how to progressively identify the causes of constipation, exclude more serious diseases, and establish a diagnosis of chronic idiopathic constipation. The article outlines the importance of obtaining a thorough medical history, conducting focused physical examinations, relevant biochemical tests, imaging examinations, and endoscopic examinations to establish an accurate diagnosis of constipation in a clinical setting. Due to its length, the article is divided into two parts. The first part primarily focuses on normal physiology, definitions, risk factors, and pathophysiology. The second part primarily discusses relevant medical histories, physical examinations, and advanced diagnostic tests. It is hoped that this article will assist patients in dealing more accurately with a seemingly minor but daily troubling issue.