Functional constipation, also known aschronic idiopathic constipation, is diagnosed when a person is experiencing constipation symptoms, but no specific cause for the problem can be identified. Because the physical cause can be found to explain the symptoms, functional constipation is one of thefunctional gastrointestinal disorders(FGDs).Westend61 / Getty ImagesSymptomsPeople who experience functional constipation report some or all of the followingsymptoms:Three or fewer bowel movements per weekHard, lumpy stoolsThe feeling ofincomplete evacuationA sensation of blockage or obstruction in the anus and/or rectumStraining during bowel movementsUse of fingers to assist in passing stool (digital evacuation)Loose stools are rare without the use oflaxativesAccording to theRome III criteria for FGDs, constipation symptoms must be experienced in at least 25 percent of all bowel movements. Symptoms also need to be present less than 3 day a week, for at least three months over the past six months, in order for a diagnosis of functional constipation to be made.Functional Constipation Versus IBSA diagnosis of functional constipation requires that your symptoms do not meet the criteria forirritable bowel syndrome(IBS). Typically, it is the absence of abdominal pain associated with bowel movements that results in the diagnosis of functional constipation as opposed to IBS.Although the two disorders have different diagnostic criteria, some researchers believe that there is not a clear-cut distinction between the two. Many healthcare providers will offer a diagnosis of IBS, even if the strict criteria are not met, to anyone who is experiencing chronic bowel problems with no identifiable cause. Many patients report that their symptom picture changes from one disorder to the other and back again over time.Functional Constipation in ChildrenThe Rome IV diagnostic criteria for functional constipation in infant, toddlers, and children differ from those for adults:Constipation is defined as two or fewer bowel movements per week.At least one episode of soiling per week (in those who are toilet trained)History of holding stool inPainful, hard bowel movementsImpacted stool in the rectumThe experience of stools that are so large they may clog the toiletYour child may also display irritability and a decreased appetite, but mood lifts and appetite increases once they are able to pass a large stool. As with functional constipation in adults, the diagnosis is only made in children who do not meet the criteria for IBS.Chronic constipation is one of the top ten problems that bring children in to see their pediatrician. It is estimated that 95 percent of the time the problem is diagnosed as functional, with only a very small percentage of children having an identifiable problem to account for their constipation symptoms. The problem is most likely to show up between the ages of two and four and is typically related to the onset of toilet training.A large percentage of children who have functional constipation also experiencefecal incontinence, as loose stool leaks out around the hard mass. Approximately one-third of children with functional constipation will demonstrate behavioral difficulties related to their symptoms.TreatmentThetreatment for functional constipationis different for adults and children. If you, or your child, are experiencing symptoms of chronic constipation, it is essential that you see a healthcare provider for an appropriate diagnostic workup. If your healthcare provider comes up with a diagnosis of constipation, they will work with you to develop a treatment plan.
Functional constipation, also known aschronic idiopathic constipation, is diagnosed when a person is experiencing constipation symptoms, but no specific cause for the problem can be identified. Because the physical cause can be found to explain the symptoms, functional constipation is one of thefunctional gastrointestinal disorders(FGDs).
Westend61 / Getty Images
Symptoms
People who experience functional constipation report some or all of the followingsymptoms:
According to theRome III criteria for FGDs, constipation symptoms must be experienced in at least 25 percent of all bowel movements. Symptoms also need to be present less than 3 day a week, for at least three months over the past six months, in order for a diagnosis of functional constipation to be made.
Functional Constipation Versus IBS
A diagnosis of functional constipation requires that your symptoms do not meet the criteria forirritable bowel syndrome(IBS). Typically, it is the absence of abdominal pain associated with bowel movements that results in the diagnosis of functional constipation as opposed to IBS.
Although the two disorders have different diagnostic criteria, some researchers believe that there is not a clear-cut distinction between the two. Many healthcare providers will offer a diagnosis of IBS, even if the strict criteria are not met, to anyone who is experiencing chronic bowel problems with no identifiable cause. Many patients report that their symptom picture changes from one disorder to the other and back again over time.
Functional Constipation in Children
The Rome IV diagnostic criteria for functional constipation in infant, toddlers, and children differ from those for adults:
Your child may also display irritability and a decreased appetite, but mood lifts and appetite increases once they are able to pass a large stool. As with functional constipation in adults, the diagnosis is only made in children who do not meet the criteria for IBS.
Chronic constipation is one of the top ten problems that bring children in to see their pediatrician. It is estimated that 95 percent of the time the problem is diagnosed as functional, with only a very small percentage of children having an identifiable problem to account for their constipation symptoms. The problem is most likely to show up between the ages of two and four and is typically related to the onset of toilet training.
A large percentage of children who have functional constipation also experiencefecal incontinence, as loose stool leaks out around the hard mass. Approximately one-third of children with functional constipation will demonstrate behavioral difficulties related to their symptoms.
Treatment
Thetreatment for functional constipationis different for adults and children. If you, or your child, are experiencing symptoms of chronic constipation, it is essential that you see a healthcare provider for an appropriate diagnostic workup. If your healthcare provider comes up with a diagnosis of constipation, they will work with you to develop a treatment plan.
5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Xin HW, Fang XC, Zhu LM, et al.Diagnosis of functional constipation: agreement between Rome III and Rome II criteria and evaluation for the practicality.J Dig Dis. 2014;15(6):314–320. doi:10.1111/1751-2980.12145Liu LW.Chronic constipation: current treatment options.Can J Gastroenterol. 2011;25 Suppl B(Suppl B):22B–28B.Siah KT, Wong RK, Whitehead WE.Chronic constipation and constipation-predominant IBS: separate and distinct disorders or a spectrum of disease?.Gastroenterol Hepatol (N Y). 2016;12(3):171–178.Levy EI, Lemmens R, Vandenplas Y, Devreker T.Functional constipation in children: challenges and solutions.Pediatric Health Med Ther. 2017;8:19–27. doi:10.2147/PHMT.S110940Van dijk M, Benninga MA, Grootenhuis MA, Last BF.Prevalence and associated clinical characteristics of behavior problems in constipated children.Pediatrics. 2010;125(2):e309-17. doi:10.1542/peds.2008-3055Additional ReadingBellini, M., et. al. “Irritable bowel syndrome and chronic constipation: Fact and fiction” World Journal of Gastroenterology 2015 28:11362-11370.Drossman DA, Chang L.Rome IV diagnostic algorithms for common gi symptoms. Raleigh: The Rome Foundation; 2016.Rome Foundation. “Rome III Diagnostic Criteria For Functional Gastrointestinal Disorders"J Gastrointestin Liver Dis.2006 Sep;15(3):307-12.Xinias, I. & Mavroudi, A. “Constipation in Childhood. An update on evaluation and management"Hippokratia2015 19:11–19.
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Xin HW, Fang XC, Zhu LM, et al.Diagnosis of functional constipation: agreement between Rome III and Rome II criteria and evaluation for the practicality.J Dig Dis. 2014;15(6):314–320. doi:10.1111/1751-2980.12145Liu LW.Chronic constipation: current treatment options.Can J Gastroenterol. 2011;25 Suppl B(Suppl B):22B–28B.Siah KT, Wong RK, Whitehead WE.Chronic constipation and constipation-predominant IBS: separate and distinct disorders or a spectrum of disease?.Gastroenterol Hepatol (N Y). 2016;12(3):171–178.Levy EI, Lemmens R, Vandenplas Y, Devreker T.Functional constipation in children: challenges and solutions.Pediatric Health Med Ther. 2017;8:19–27. doi:10.2147/PHMT.S110940Van dijk M, Benninga MA, Grootenhuis MA, Last BF.Prevalence and associated clinical characteristics of behavior problems in constipated children.Pediatrics. 2010;125(2):e309-17. doi:10.1542/peds.2008-3055Additional ReadingBellini, M., et. al. “Irritable bowel syndrome and chronic constipation: Fact and fiction” World Journal of Gastroenterology 2015 28:11362-11370.Drossman DA, Chang L.Rome IV diagnostic algorithms for common gi symptoms. Raleigh: The Rome Foundation; 2016.Rome Foundation. “Rome III Diagnostic Criteria For Functional Gastrointestinal Disorders"J Gastrointestin Liver Dis.2006 Sep;15(3):307-12.Xinias, I. & Mavroudi, A. “Constipation in Childhood. An update on evaluation and management"Hippokratia2015 19:11–19.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Xin HW, Fang XC, Zhu LM, et al.Diagnosis of functional constipation: agreement between Rome III and Rome II criteria and evaluation for the practicality.J Dig Dis. 2014;15(6):314–320. doi:10.1111/1751-2980.12145Liu LW.Chronic constipation: current treatment options.Can J Gastroenterol. 2011;25 Suppl B(Suppl B):22B–28B.Siah KT, Wong RK, Whitehead WE.Chronic constipation and constipation-predominant IBS: separate and distinct disorders or a spectrum of disease?.Gastroenterol Hepatol (N Y). 2016;12(3):171–178.Levy EI, Lemmens R, Vandenplas Y, Devreker T.Functional constipation in children: challenges and solutions.Pediatric Health Med Ther. 2017;8:19–27. doi:10.2147/PHMT.S110940Van dijk M, Benninga MA, Grootenhuis MA, Last BF.Prevalence and associated clinical characteristics of behavior problems in constipated children.Pediatrics. 2010;125(2):e309-17. doi:10.1542/peds.2008-3055
Xin HW, Fang XC, Zhu LM, et al.Diagnosis of functional constipation: agreement between Rome III and Rome II criteria and evaluation for the practicality.J Dig Dis. 2014;15(6):314–320. doi:10.1111/1751-2980.12145
Liu LW.Chronic constipation: current treatment options.Can J Gastroenterol. 2011;25 Suppl B(Suppl B):22B–28B.
Siah KT, Wong RK, Whitehead WE.Chronic constipation and constipation-predominant IBS: separate and distinct disorders or a spectrum of disease?.Gastroenterol Hepatol (N Y). 2016;12(3):171–178.
Levy EI, Lemmens R, Vandenplas Y, Devreker T.Functional constipation in children: challenges and solutions.Pediatric Health Med Ther. 2017;8:19–27. doi:10.2147/PHMT.S110940
Van dijk M, Benninga MA, Grootenhuis MA, Last BF.Prevalence and associated clinical characteristics of behavior problems in constipated children.Pediatrics. 2010;125(2):e309-17. doi:10.1542/peds.2008-3055
Bellini, M., et. al. “Irritable bowel syndrome and chronic constipation: Fact and fiction” World Journal of Gastroenterology 2015 28:11362-11370.Drossman DA, Chang L.Rome IV diagnostic algorithms for common gi symptoms. Raleigh: The Rome Foundation; 2016.Rome Foundation. “Rome III Diagnostic Criteria For Functional Gastrointestinal Disorders"J Gastrointestin Liver Dis.2006 Sep;15(3):307-12.Xinias, I. & Mavroudi, A. “Constipation in Childhood. An update on evaluation and management"Hippokratia2015 19:11–19.
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