Functional constipation: Rome IV criteria
Checks age-appropriate Rome IV criteria and records stool type on the Bristol scale.
Result
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Formula and thresholds
Under 4: at least 2 of the following for 1 month (incontinence and toilet-obstructing stools only in toilet-trained children). Age 4 and older: at least 2 criteria, at least once a week, for at least 1 month, without meeting criteria for irritable bowel syndrome.
Clinical note
Constipation is among the most common causes of daytime wetting, recurrent UTI and treatment-resistant bedwetting; ask about it in every toilet-trained child with febrile or recurrent UTI (EAU 2026). Occult constipation is common: parents may see soft stools while the rectum is loaded. With red flags (delayed passage of meconium, blood in stool, failure to thrive, lumbosacral skin changes, neurological signs), further evaluation is needed before diagnosing functional constipation.
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