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. 2019 Nov 13;5(2):121–134. doi: 10.1016/j.ekir.2019.11.002

Table 1.

Rome IV diagnostic criteriaa 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
a

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