Criteria of the Paris Consensus on Childhood Constipation Terminology (PaCCT) Group for Chronic Constipation

 

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

Parameters	Findings	Points
bowel movements per week	>= 3 per week	0
	< 3 per week	1
episodes of fecal incontinence per week	<= 1 per week	0
	> 1 per week	1
large stool on exam	absent	0
	present	1
large stool passed	absent	0
	present	1
retentive posture or withholding	absent	0
	present	1
pain on defecation	absent	0
	present	1

 

where:

• 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)

 

Interpretation:

• minimum score: 0

• maximum score: 6

• A score >= 2 indicates chronic constipation.

 

Limitations:

• Not everyone who meets these criteria will have chronic constipation. A person could pass several stools per day and still meet the criteria.