Table 1.

Rome III criteria for chronic constipation and for IBS with constipation

Rome III criteria for chronic constipationa

1. Must include two or more of the following:

a. Straining during at least 25% of defecations

b. Lumpy or hard stools in at least 25% of defecations

c. Sensation of incomplete evacuation for at least 25% of defecations

d. Sensation of anorectal obstruction/blockage for at least 25% of defecations

e. Manual maneuvers to facilitate at least 25% of defecations (e.g. digital evacuation, support of the pelvic floor)

f. Fewer than three defecations per week

2. Loose stools are rarely present without the use of laxatives

3. Insufficient criteria for irritable bowel syndrome

Rome III criteria for IBS with constipationb

Recurrent abdominal pain or discomfortc at least three days/month in the last

three months associated with two or more of the following:

1. Improvement with defecation

2. Onset associated with a change in frequency of stool

3. Onset associated with a change in form (appearance) of stool

Hard or lumpy stools (Bristol Stool Scale 1 or 2) >25% and loose (mushy) or watery stools (Bristol Stool Scale 6 or 7) <25% of bowel movements.

^aCriteria fulfilled for the last three months with symptom onset at least six months prior to diagnosis.

^bCriterion fulfilled for the last 3 months with symptom onset at least 6 months prior to diagnosis.

^c“Discomfort” means an uncomfortable sensation not described as pain.

In pathophysiology research and clinical trials, a pain/discomfort frequency of at least 2 days a week during screening evaluation is recommended for subject eligibility.