Functional constipation

Rome IV defintion: Must include two or more of the following:

1. Straining during more than ¼ (25%) of defecations
   1. Lumpy or hard stools (Bristol Stool Form Scale 1-2) more than ¼ (25%) of defecations
   2. Sensation of incomplete evacuation more than ¼ (25%) of defecations
   3. Sensation of anorectal obstruction/blockage more than ¼ (25%) of defecations
   4. Manual maneuvers to facilitate more than ¼ (25%) of defecations (e.g., digital evacuation, support of the pelvic floor)
   5. Fewer than three SBM per week
2. Loose stools are rarely present without the use of laxatives
3. Insufficient criteria for irritable bowel syndrome