Rome IV Diagnostic Criteria for Infant Dyschezia
Official Rome IV criteria for the diagnosis of infant dyschezia.
Use in an otherwise healthy infant <9 months with symptoms of infant dyschezia such as crying, turning red and straining for several minutes before successfully or unsuccessfully having a bowel movement.
Infants with any of the following alarm features must be evaluated further:
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Constipation.
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Failure to thrive.
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Bloody stools.
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Vomiting.
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Excessive irritability or crying.
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Symptoms after 9 months of age.
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Abdominal distension.
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Abnormal physical exam.
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Fever or illness.
If diagnosis not met (negative):
Current symptoms are unlikely to be related to infant dyschezia. Consider further assessment as clinically indicated. Also, see pearls and pitfalls above.
If meets diagnosis (positive):
Likely diagnosis of infant dyschezia. Provide reassurance.
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Parental reassurance including the explanation that the infant needs to learn to relax the pelvic floor at the same time as bearing down in order to defecate successfully. The infant will learn this on his or her own in the course of a few weeks.
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External rectal stimulation should be avoided as this can interfere with the infant’s natural ability to learn to defecate spontaneously.
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Laxatives are not indicated and should be avoided.
This calculator should only be used in infants who do not have signs or symptoms suggestive of an anatomical, metabolic, infectious, neurologic or behavioral cause of their symptoms based on a detailed clinical history, physical exam and initial work-up.