The Paris Consensus on Childhood Constipation Terminology (PaCCT) Group developed criteria for the diagnosis of chronic constipation in children.
Patient selection: pediatric
Duration: past 8 weeks (or more)
Criteria - two or more of the following:
(1) bowel movements occur 0 to 2 times per week (< 3 times per week)
(2) fecal incontinence occurs 2 or more times per week (> 1 episode per week)
(3) large stools are present in the rectum or can be palpated during the physical exam
(4) stool is passed that is large enough to obstruct the toilet
(5) display of a retentive posture and/or withholding behaviors
(6) pain on defecation
bowel movements per week
>= 3 per week
< 3 per week
episodes of fecal incontinence per week
<= 1 per week
> 1 per week
large stool on exam
large stool passed
retentive posture or withholding
pain on defecation
• Obstruction of the toilet by a large defecation should be by stool alone and not be due to the use of toilet paper. Also toilets differ in how difficult they are to obstruct.
• In practice some variation in the number and type of criteria can be expected.
total score =
= SUM(points for all 6 parameters)
• minimum score: 0
• maximum score: 6
• A score >= 2 indicates chronic constipation.
• Not everyone who meets these criteria will have chronic constipation. A person could pass several stools per day and still meet the criteria.
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