FUNCTIONAL CONSTIPATION

https://theromefoundation.org/rome-iv/rome-iv-criteria/

 FUNCTIONAL CONSTIPATION

Diagnostic criteria*

• Must include two or more of the following:**
• Straining during more than ¼ (25%) of defecations
• Lumpy or hard stools (Bristol Stool Form Scale 1-2) more than ¼ (25%) of defecations
• Sensation of incomplete evacuation more than ¼ (25%) of defecations
• Sensation of anorectal obstruction/blockage more than ¼ (25%) of defecations
• Manual maneuvers to facilitate more than ¼ (25%) of defecations (e.g., digital evacuation, support of the pelvic floor)
• Fewer than three SBM per week
• Loose stools are rarely present without the use of laxatives
• Insufficient criteria for irritable bowel syndrome

*Criteria fulfilled for the last 3 months with symptom onset at least 6 months prior to diagnosis
**For research studies, patients meeting criteria for opioid-induced constipation (OIC) should not be given a diagnosis of FC because it is difficult to distinguish between opioid side effects and other causes of constipation.
However, clinicians recognize that these two conditions may overlap.

FUNCTIONAL ABDOMINAL BLOATING/DISTENSION

Diagnostic criteria* Must include both of the following:

• Recurrent bloating and/or distension occurring on average at least 1 day/week;  abdominal bloating and/or distension  predominates over other symptoms.**
• There are insufficient criteria for a diagnosis of irritable bowel syndrome, functional constipation, functional diarrhea, or post-prandial distress syndrome.

*Criteria fulfilled for the last 3 months with symptom onset at least 6 months prior to diagnosis
**Mild pain related to bloating may be present as well as minor bowel movement abnormalities