Constipation, functional

Constipation is a delay or difficulty in defaecation marked by infrequent bowel movement and the “passage of dry and hard stools, which may cause painful defecation”. This leads to stool retention with two or fewer defaecations per week and is often accompanied by abdominal pain (Benninga et al., 2016, Koppen et al., 2015).

According to Rome IV the diagnostic criteria (Benninga et al., 2016) 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 faecal 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”