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Table 1 Rome IV diagnostic criteria for functional defecation disorders

From: Does sequential balloon expulsion test improve the screening of defecation disorders?

Rome IV Diagnostica criteria (a) for functional defecation disorders
1. The patient must satisfy diagnostic criteria for functional constipation and /or Irritable Bowel Syndrome with constipation
2. During repeated attempts to defecate, there must be features of impaired evacuation, as demonstrated by 2 of the 3 following 3 tests:
a. Abnormal balloon expulsion test
b. Abnormal anorectal evacuation pattern with manometry or anal surface electromyography
c. Impaired rectal evacuation by imaging
(a) Criteria fulfilled for the last 3 months with symptoms onset at least 6 months before diagnosis