Functional constipation may involve difficult, infrequent and/or incomplete defecation. Criteria for its identification were defined at the Rome II Conference for Functional Gastrointestinal Disorders.


Timing - both of the following:

(1) for at least 12 weeks (need not be consecutive)

(2) in past 12 months


Criteria - 2 or more of the following:

(1) straining in > 25% of defecations

(2) lumpy or hard stools in > 25% of defecations

(3) sensations of incomplete evacuation in > 25% of defecations

(4) sensation of anorectal obstruction and/or blockade in > 25% of defecations

(5) manual maneuvers to facilitate > 25% of defecations. This may include digital evacuation or support of the pelvic floor.

(6) < 3 defecations per week


Exclusion criteria:

(1) loose stools are not present

(2) insufficient criteria for irritable bowel syndrome (ie, does not meet the criteria for IBS).



• It is important to distinguish a patient with constipation from those with irritable bowel syndrome with the constipation-predominant pattern.


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