Editing Functional constipation (section)

== Diagnosis ==
Functional constipation cannot be diagnosed with particular testing; instead, the Rome criteria, a consensus of experts, is used to make this diagnosis.<ref name="Functional Gastrointestinal Disorders">{{cite journal | last=Drossman | first=Douglas A. | title=Functional Gastrointestinal Disorders: History, Pathophysiology, Clinical Features, and Rome IV | journal=Gastroenterology | publisher=Elsevier BV | volume=150 | issue=6 | year=2016 | issn=0016-5085 | doi=10.1053/j.gastro.2016.02.032 | pages=1262–1279.e2 | pmid=27144617 | url=https://cdr.lib.unc.edu/downloads/12579z328 | access-date=2024-06-30 | archive-date=2023-10-18 | archive-url=https://web.archive.org/web/20231018035944/https://cdr.lib.unc.edu/downloads/12579z328 | url-status=live }}</ref> The Rome IV criteria define functional constipation as meeting at least two of the six requirements given below:<ref name="Rome">{{cite web | title=Rome IV Criteria | website=Rome Foundation | date=2023-03-06 | url=https://theromefoundation.org/rome-iv/rome-iv-criteria/ | access-date=2024-06-10 | archive-date=2022-01-19 | archive-url=https://web.archive.org/web/20220119204636/https://theromefoundation.org/rome-iv/rome-iv-criteria/ | url-status=live }}</ref>

# Over ¼ (25%) of defecations involve straining.<ref name="Rome"/>
# More than ¼ (25%) of defecations result in lumpy or hard stools ([[Bristol stool scale|Bristol Stool Form Scale]] 1-2).<ref name="Rome"/>
# Sensation of partial evacuation for over ¼ (25%) of the defecations.<ref name="Rome"/>
# Sensation of anorectal blockage or obstruction during more than ¼ (25%) of bowel movements.<ref name="Rome"/>
# Manual techniques (such as pelvic floor support and digital evacuation) to assist in more than ¼ (25%) of defecations.<ref name="Rome"/>
# Less than three weekly spontaneous bowel movements.<ref name="Rome"/>
# Loose stools are rarely seen without the use of laxatives.<ref name="Rome"/>
# Not enough criteria met to diagnose [[irritable bowel syndrome]].<ref name="Rome"/>

A thorough history and physical examination should be performed while evaluating constipation.<ref name="Evaluation and Management">{{cite journal | last1=Jani | first1=Bhairvi | last2=Marsicano | first2=Elizabeth | title=Constipation: Evaluation and Management | journal=Missouri Medicine | publisher=Missouri State Medical Association | volume=115 | issue=3 | date=2024-03-14 | pages=236–240 | pmid=30228729 | pmc=6140151 }}</ref> Along with push and squeeze maneuvers, a comprehensive [[digital rectal exam]] (DRE) is a crucial component of the clinical examination.<ref name="Digital Rectal">{{cite journal | last1=Tantiphlachiva | first1=Kasaya | last2=Rao | first2=Priyanka | last3=Attaluri | first3=Ashok | last4=Rao | first4=Satish S.C. | title=Digital Rectal Examination Is a Useful Tool for Identifying Patients With Dyssynergia | journal=Clinical Gastroenterology and Hepatology | publisher=Elsevier BV | volume=8 | issue=11 | year=2010 | issn=1542-3565 | doi=10.1016/j.cgh.2010.06.031 | pages=955–960| pmid=20656061 }}</ref>

Generally speaking, additional laboratory testing should be carried out only in cases of uncertainty or to rule out underlying medical conditions such as [[hypothyroidism]] or [[Coeliac disease|celiac disease]]. [[Abdominal radiography]], with or without the introduction of radio-opaque markers to determine colonic transit time, and [[abdominal ultrasonography]] are frequently employed supplementary tests in the diagnosis of constipation.<ref name="Clinical practice">{{cite journal | last1=Tabbers | first1=Merit M. | last2=Boluyt | first2=Nicole | last3=Berger | first3=Marjolein Y. | last4=Benninga | first4=Marc A. | title=Clinical practice | journal=European Journal of Pediatrics | publisher=Springer Science and Business Media LLC | volume=170 | issue=8 | date=2011-06-24 | issn=0340-6199 | doi=10.1007/s00431-011-1515-5 | pages=955–963| pmid=21701812 }}</ref>

Chronic idiopathic constipation is similar to constipation-predominant [[irritable bowel syndrome]] (IBS-C); however, people with CIC do not have other symptoms of IBS, such as abdominal pain.<ref name="ACG">{{Cite web |url=http://www.acg.gi.org/patients/gihealth/pdf/functional.pdf |title=Americal College of Gastroenterology: Fuinctional Bowel Disorders |access-date=2010-06-26 |archivedate=2011-09-27 |archiveurl=https://web.archive.org/web/20110927051722/http://www.acg.gi.org/patients/gihealth/pdf/functional.pdf |url-status=deviated }}</ref>