Rome IV Diagnostic Criteria for Infant Functional Constipation
INSTRUCTIONS
Use in infants and toddlers (<4 years of age) with symptoms suggestive of constipation such as passing hard, painful stools and exhibiting withholding behaviors for at least 1 month.
Patients with any of the following features must be evaluated clinically for other diagnoses even though functional constipation may be present:
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Constipation starting extremely early in life (<1 month).
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Passage of meconium >48.
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Family history of Hirschsprung disease.
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Ribbon stools.
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Blood in the stool in the absence of anal fissures.
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Failure to thrive or unintentional weight loss.
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Fever.
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Bilious vomiting.
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Severe abdominal distension.
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Abnormal physical exam findings including:
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Tuft of hair on spine or sacral dimple.
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Gluteal cleft deviation.
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Perianal fistula.
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Abnormal position of anus.
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Absent anal or cremasteric reflex.
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Anal scars.
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Decreased lower extremity strength/tone/reflex.
Diagnostic Result:
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- Beate Beinvogl, MD, MPH
- Samuel Nurko, MD, MPH