Constipation affects the quality of life of many 'at risk' groups of people. Laxatives are the dominant management strategy whose long-term use is ineffective and very costly to the NHS prescription bill and in the use of health staff resources. The development of a user-friendly, evidence-based clinical guideline (The effective management of constipation in primary care) has the potential to change the present situation by providing healthcare practitioners with an aide-mémoire to assist clinical reasoning, in order to re-evaluate current practice and suggest combined alternative treatment strategies. Early indications of use of the guideline suggest holistic individualised bowel management programmes can significantly reduce laxative use and nursing interventions and lead to improved quality of life.