Criteria

Constipation in childhood[38][39]

Based on the ROME IV criteria. For diagnosis of functional constipation (i.e., no organic cause) in infants up to 4 years of age, symptoms must include 1 month of at least 2 of the following:

  • Two or fewer defecations per week

  • History of excessive stool retention or retentive posturing

  • History of painful or hard bowel movements

  • Presence of a large faecal mass in the rectum

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

  • History of large diameter stools that may obstruct the toilet

  • At least 1 episode per week of faecal incontinence after the child has acquired toileting skills.

In children over 4 years old, symptoms should be present once a week for at least 1 month, with insufficient criteria for the diagnosis of irritable bowel syndrome.

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