Table 1.

Rome IV Criteria for Defining Opioid-Induced Constipation

1) New or worsening symptoms of constipation when initiating, changing or increasing opioid therapy

2) Diagnostic criteria for functional constipation Must include two or more of the following symptoms* Straining, Lumpy or hard stools, Sensation of incomplete evacuation, Sensation of anorectal obstruction/blockage, Use of manual maneuvers to facilitate defecation or <3 Spontaneous bowel movements (SBM) per week.

Abdominal pain and/or bloating may be present but are not predominant

Insufficient criteria for irritable bowel syndrome

Loose stools rarely present without laxatives

Notes: Data from Simren et al.⁹ *With a frequency cut-off of 25% of defecations.