Rome IV Criteria for Opioid-Related Constipation

Criteria for the diagnosis of opioid-related constipation - all of the following:

(1) symptoms of constipation are new or worse if opioid therapy is started or increased

(2) >= 2 of the following are present:

(2a) straining during > 25% of defecations

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

(2c) sensation of incomplete evacuation > 25% of defecations

(2d) sensation of anorectal obstruction/blockage > 25% of defecations

(2e) manual maneuvers needed to assist > 25% of defecations

(2f) < 3 spontaneous bowel movements per week

(3) The stools are rarely loose unless that patient is taking laxative therapy.