Rome III Criteria for Chronic Constipation
A patient has chronic constipation if the patient has:
Symptom onset more than 6 months prior to the diagnosis, with the following criteria fulfilled for the past 3 months:
-Doesn’t meet the criteria for a diagnosis of irritable bowel syndrome,
-Rarely has loose stools without the use of laxatives, and
-Mets two or more of the following criteria:
- Less than three bowel movements per week
- Manual maneuvers are necessary to facilitate defecation more than 25% of the time.
- Hard or lumpy stools more than 25% of the time
- Sensation of incomplete evacuation more than 25% of the time
- Sensation of anorectal obstruction more than 25%of the time
- Straining with defecation more than 25% of the time.
***Notice that this definition includes several key components: Reduced frequency, Consistency (hard or lumpy), Difficulty passing stools (straining), and Incomplete evacuation.
American College of Gastroenterology
The American College of Gastroenterology defined chronic constipation as “unsatisfactory defecation characterized by infrequent stool, difficult stool passage or both at least for previous 3 months”. Difficult stool passage includes straining, a sense of difficulty passing stool, incomplete evacuation, hard/lumpy stool, prolonged time to stool or need for manual maneuvers to pass stool”
A Canadian Consensus Group
A Canadian consensus group defined chronic constipation as being “symptom-based including fewer than 3 stools per week, stool form that is mostly hard or lumpy and difficult stool passage (need to strain or incomplete evacuation) for more than 6 months”
AAFP Journal, 2015
The AAFP journal in a 2015 article titled Management of constipation in adults says,
“Constipation is a clinical diagnosis based on symptoms of incomplete elimination of stool, difficulty passing stool, or both. Patients typically experience other symptoms such as hard stools, abdominal bloating, pain, and distention. Constipation may be present with normal stool frequency, defined as at least one stool three times per week, or with daily bowel movements. Chronic constipation is characterized by the presence of symptoms for at least three months out of the preceding 12 months.”
Sources:
Gray, James R. “What Is Chronic Constipation? Definition and Diagnosis.” Canadian Journal of Gastroenterology 25.Suppl B (2011): 7B–10B.
Shih, David Q., and Lola Y. Kwan. “All Roads Lead to Rome: Update on Rome III Criteria and New Treatment Options.” The gastroenterology report 1.2 (2007): 56–65.
Am Fam Physician. 2015 Sep 15;92(6):500-504. Management of Constipation in Older Adults
http://emedicine.medscape.com/article/184704-overview