What Is the Rome IV Criteria for Constipation?

By Robert Palmer

What Is the Rome IV Criteria for Constipation?

Constipation is a common digestive problem that affects millions of people worldwide. It is characterized by infrequent bowel movements, difficulty passing stools, and a feeling of incomplete evacuation. To provide a standardized definition and diagnostic criteria for constipation, experts developed the Rome IV criteria.

Rome IV Criteria

The Rome IV criteria are a set of guidelines used by healthcare professionals to diagnose constipation. These criteria were established by an international group of gastrointestinal experts and are considered the gold standard in defining and classifying functional gastrointestinal disorders.

According to the Rome IV criteria, constipation can be diagnosed when the following criteria are met:

  • Diagnostic Criteria: The presence of at least two of the following symptoms for at least three months before diagnosis:
    • Straining during more than 25% of defecations
    • Lumpy or hard stools in more than 25% of defecations
    • Sensation of incomplete evacuation in more than 25% of defecations
    • Sensation of anorectal obstruction/blockage in more than 25% of defecations
    • Manual maneuvers required to facilitate more than 25% of defecations (e.g., digital evacuation, support of the pelvic floor)
    • Fewer than three spontaneous bowel movements per week
  • Subtypes: Based on the stool consistency, constipation can be further classified into different subtypes:
    • Rome IV Subtype: Functional Constipation with Hard/Lumpy Stools: At least one of the following symptoms should be present:
      • Loose stools are rarely present without the use of laxatives
      • There are insufficient criteria for irritable bowel syndrome (IBS)
    • Rome IV Subtype: Functional Constipation with Soft Stools: At least one of the following symptoms should be present:
      • Absence of hard/lumpy stools
      • Loose stools are present for at least a quarter of bowel movements
      • Symptoms should be present for at least three months before diagnosis
  • Exclusion Criteria: The presence of alarm features that may indicate other underlying diseases. These include, but are not limited to:
    • Blood in the stool
    • Unintentional weight loss
    • Anemia
    • Fever
    • Familial history of colon cancer, inflammatory bowel disease, or celiac disease

    The Rome IV criteria help healthcare professionals diagnose constipation accurately and differentiate it from other gastrointestinal disorders. By following these criteria, doctors can provide appropriate treatment and management strategies tailored to each patient’s specific subtype and underlying cause.

    In Conclusion

    The Rome IV criteria provide a standardized definition and diagnostic framework for constipation. By meeting specific symptoms and subtypes outlined in these criteria, healthcare professionals can confidently diagnose constipation and develop effective treatment plans. If you experience chronic constipation, it is recommended to consult a healthcare professional who can evaluate your symptoms based on the Rome IV criteria and provide appropriate care.