Functional Constipation

Must include 1 mo of at least 2 of the following in infants up to 4 yr of age:

• 1) Two or fewer defecations per week 2) History of excessive stool retention 3) History of painful or hard bowel movements 4) History of large-diameter stools 5) Presence of a large fecal mass in the rectum

In toilet-trained children, the following additional criteria may be used:

• 6) At least 1 episode/wk of incontinence after the acquisition of toileting skills 7) History of large-diameter stools that may obstruct the toilet