Rome IV Criteria

Rome IV Diagnostic Criteria for Functional Constipation in Children

Neonate/Toddler

(Benninga et al., 2016)

Child/Adolescent

(Hyams et al., 2016)

Infants and toddlers up to 4 years:

One month of at least 2 of the following -

1. Two of 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 large fecal mass in the rectum

In Toilet-Trained Children, the following additional criteria may be used:
6. At least one episode per week of incontinence
7. History of large diameter stools that may obstruct the toilet

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

 

Child/Adolescent with Developmental Age of 4 Years:
Minimum of one month of ≥ 2 of the following, occurring at least once a week -

• ≤ 2 defecations in the toilet per week in a child ≥ 4 years of age
• ≥ 1 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 toilet

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