미국과 영국에서 epidemiological studies에 근거하여 변비는 일주일에 3회 미만의 빈도로 정의되어 왔으나, 이 정의는 보편적으로 적용되지는 않습니다.
Constipation has been defined as a stool frequency of less than three per week based upon epidemiological studies in the United States and the United Kingdom. However, this definition is not universally applicable.
기능적 변비에 대한 Rome IV 진단 기준은 다음과 같은 항목들이 적어도 3개월 이상 존재해야 합니다(증상은 진단 이전 적어도 6개월 이전에 존재해야 합니다)
An international working committee recommended diagnostic criteria (Rome IV) for functional constipation [7,8]. The diagnosis should be based upon the presence of the following for at least three months (with symptom onset at least six months prior to diagnosis).
(1) Must include two or more of the following:
● Straining during more than 25 percent of defecations.
● Lumpy or hard stools (Bristol Stool Scale Form 1-2) in more than 25 percent of defecations(Figure)
● Sensation of incomplete evacuation for more than 25 percent of defecations.
● Sensation of anorectal obstruction/blockage for more than 25 percent of defecations.
● Manual maneuvers to facilitate more than 25 percent of defecations (eg, digital evacuation, support of the pelvic floor).
● Fewer than three spontaneous bowel movements per week.
(2) Loose stools are rarely present without the use of laxatives
(3) There are insufficient criteria for IBS.
Bristol stool form scale
The Bristol stool form scale (BSFS)[1] is a useful tool to evaluate bowel habits. Abnormal stool forms are types 1 to 2 (constipation) and types 6 to 7 (diarrhea). The BSFS has been shown to be a reliable surrogate marker for colonic transit.[2]
Reference:
Lewis SJ, Heaton KW. Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol 1997; 32:920.
Patel P, Bercik P, Morgan DG, et al. Prevalence of organic disease at colonoscopy in patients with symptoms compatible with irritable bowel syndrome: cross-sectional survey. Scand J Gastroenterol 2015; 50:816.
Reproduced from: Lacy BE, Mearin F, Chang L, et al. Bowel disorders. Gastroenterology 2016; 150:1393. Illustration used with the permission of Elsevier Inc. All rights reserved.
REF. UpToDate 2019.08.26
