Table 1 Rome IV diagnostic criteria 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