What are the criteria for constipation and which complaints are related to constipation?

Updated: Jul 05, 2019
  • Author: Marc D Basson, MD, PhD, MBA, FACS; Chief Editor: BS Anand, MD  more...
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Answer

According to the Rome IV criteria for constipation, a patient must have experienced at least two of the following symptoms over the preceding 6 months:

  • Fewer than three spontaneous bowel movements per week

  • Straining for more than 25% of defecation attempts

  • Lumpy or hard stools or at least 25% of defecation attempts

  • Sensation of anorectal obstruction or blockage for at least 25% of defecation attempts

  • Sensation of incomplete defecation for at least 25% of defecation attempts

  • Manual maneuvering required to defecate for at least 25% of defecation attempts

In addition, the patient must rarely have loose stools present without use of a laxative and must not meet Rome IV criteria for irritable bowel syndrome (IBS).

A constipated patient may be otherwise totally asymptomatic or may complain of one or more of the following:

  • Abdominal bloating

  • Pain on defecation

  • Rectal bleeding

  • Spurious diarrhea

  • Low back pain


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