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Constipation: Rome IV Child/Adolescent Criteria for Constipation

Child/Adolescent, Hyams et al. (2016)

A minimum of 1 month of two or more of the following occurring at least once per week, with insufficient criteria for a diagnosis of irritable bowel:

  • Two or fewer defecation in the toilet per week in a child of developmental age of at least 4 years.
  • At least one episode of fecal incontinence per week.
  • History of retentive posturing or excessive volitional stool retention.
  • History of painful or hard bowel movements.
  • Presence of a large fecal mass in the rectum.
  • History of large diameter stools that can obstruct the toilet after appropriate evaluation, the symptoms cannot be fully explained by another medical condition.

After appropriate evaluation, the symptoms cannot be fully explained by another medical condition.

 

These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.