Table 1 Rome IV criteria for functional constipation

Must include 1 month of at least 2 of the following in infants up to 4 years of age:

1. 2 or 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 a large faecal mass in the rectum

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

6. At least 1 episode/week of incontinence after the acquisition of toileting skills

7. History of large-diameter stools that may obstruct the toilet

Must include 2 or more of the following occurring at least once per week for a minimum of 1 month with insufficient criteria for a diagnosis of irritable bowel syndrome

1. 2 or fewer defecations in the toilet per week in a child of a developmental age of at least 4 years

2. At least 1 episode of faecal incontinence per week

3. History of retentive posturing or excessive volitional stool retention

4. History of painful or hard bowel movements

5. Presence of a large faecal mass in the rectum

6. History of large-diameter stools that can obstruct the toilet

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