Rome IV Diagnostic Criteria for Functional Constipation
Official Rome IV criteria for the diagnosis of functional constipation.
Use in patients with symptoms suggestive of constipation for at least the last 3 months.
Patients with any of the following features must be evaluated clinically for other diagnoses even though functional constipation may be present:
- Signs or symptoms of gastrointestinal bleeding.
- Unexplained iron deficiency anemia.
- Unintentional weight loss.
- Palpable abdominal mass or lymphadenopathy on exam.
- Family history of colon cancer and have not had age-appropriate colon cancer screening.
- Onset of symptoms age ≥50 years and have not had age-appropriate colon cancer screening.
- Sudden or acute onset of new change in bowel habit.
If diagnosis not met (negative):
Symptoms unlikely to be caused by functional constipation. Consider further assessment as clinically indicated.
If meets diagnosis (positive):
Likely diagnosis of functional constipation. Consider initiating treatment.
Management of functional constipation (also known as chronic idiopathic constipation) may include:
- Adequate dietary fiber intake and supplementation.
- Osmotic laxatives (e.g. PEG-3350, lactulose).
- Stimulant laxatives (e.g. bisacodyl, senna).
- Secretagogues (e.g. linaclotide, plecanatide, lubiprostone).
- 5-HT4 receptor agonist (e.g. prucalopride).
The choice of therapy is outside the scope of this calculator and will depend on clinical context.
This calculator should only be used in patients where a secondary cause of constipation (e.g. mechanical obstruction, systemic illness, medications) is not suspected based on clinical history, physical exam, and initial workup.