Definition and symptoms of constipation in adults
The normal frequency of bowel motions can vary between individuals from 3 times per day to 3 times per week. It is important to clarify what a patient means when they complain of constipation.
Exclude other causes of constipation before making a diagnosis of functional constipation. Functional constipation should not be defined by stool frequency alone, but by the presence of at least 2 of the following, for at least 3 months:
- 2 or fewer motions per week
- straining at more than 25% of defecations
- a feeling of incomplete evacuation at 25% or more defecations
- hard lumpy stools for at least 25% of defecations
- sensation of anorectal obstruction or blockage for at least 25% of defecations
- manual manoeuvres needed to facilitate at least 25% of defecations (eg digital evacuation, support of the pelvic floor)Rome Foundation Inc., 2016.
Ask all patients with constipation about symptoms of dyssynergic defecation (a functional defecation disorder).