Table 1.

Rome IV diagnostic criteria^a for functional constipation²⁸

1. Must include 2 or more of the following:

a. Straining during more than one-fourth (25%) of defecations

b. Lumpy or hard stools (Bristol stool form scale 1 or 2) more than one-fourth (25%) of defecations

c. Sensation of incomplete evacuation more than one-fourth (25%) of defecations

d. Sensation of anorectal obstruction/blockage more than one-fourth (25%) of defecations

e. Manual maneuvers to facilitate more than one-fourth (25%) of defecations (e.g., digital evacuation, support of the pelvic floor)

f. Fewer than 3 spontaneous bowel movements per week

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

3. Insufficient criteria for irritable bowel syndrome

^aCriteria fulfilled for the past 3 months with symptom onset at least 6 months before diagnosis.