Constipation (functional)

Constipation often occurs in the first year of live with a “passage of dry and hard stools, which may cause painful defecation” (Benninga et al. 2016). According to Rome IV the diagnostic criteria for functional constipation “includes one month of at least two of the following criteria in infants and children up to four years of age:

1. Two or fewer defecations per week
2. History of excessive stool retention
3. History of painful or hard bowel movements
4. History of large-diameter stools
5. Presence of a large fecal mass in the rectum

In toilet-trained children, the following additional criteria may be used:

6. At least one episode/week of incontinence after the acquisition of toileting skills
7. History of large-diameter stools that may obstruct the toilet” (Benninga et al. 2016)