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