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Rome IV criteria for the diagnosis of functional constipation in children

Rome IV criteria for the diagnosis of functional constipation in children
Infants and toddlers up to 4 years old
At least 2 of the following present for at least 1 month:
2 or fewer defecations per week
History of excessive stool retention
History of painful or hard bowel movements
History of large-diameter stools
Presence of a large fecal mass in the rectum
In toilet-trained children, the following additional criteria may be used:
At least 1 episode/week of incontinence after the acquisition of toileting skills
History of large-diameter stools that may obstruct the toilet
Children and adolescents (developmental age ≥4 years)
At least 2 of the following present at least once per week for at least 1 month:*
2 or fewer defecations in the toilet per week
At least 1 episode of fecal incontinence per week
History of retentive posturing or excessive volitional stool retention
History of painful or hard bowel movements
Presence of a large fecal mass in the rectum
History of large-diameter stools that may obstruct the toilet
The symptoms cannot be fully explained by another medical condition
* In addition, the symptoms are insufficient to fulfill the diagnostic criteria of irritable bowel syndrome.
Data from:
  1. Benninga MA, Faure C, Hyman PE, et al. Childhood Functional Gastrointestinal Disorders: Neonate/Toddler. Gastroenterology 2016.
  2. Hyams JS, Di Lorenzo C, Saps M, et al. Functional Disorders: Children and Adolescents. Gastroenterology 2016.
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