Constipation is a common digestive condition that can cause a variety of symptoms, such as abdominal discomfort and pain, gurgling, loss of appetite, or weight loss. The current gold standard for diagnosing functional constipation is the ROME-III criteria. This criteria assesses the frequency of defecations and is used to determine if a patient is constipated. Constipation is generally defined as having three or fewer bowel movements per week that are difficult to evacuate.
In recent years, there have been notable advances in the diagnosis of constipation and defecation disorders. To determine how well each definition works in identifying constipation compared to reference standards, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for each simple definition using the modified Rome III criteria (chronic constipation) and the modified Rome III criteria (subchronic constipation) as reference standards. The PPV for this definition was 37%, and it was found that of all the participants considered constipated according to this definition, only 37% were also considered constipated according to the reference standard (Rome III).Physiological tests of colorectal function need to be performed in order to be able to more accurately characterize the underlying mechanisms of constipation, especially in patients who do not respond to simple measures such as fiber supplements and over-the-counter laxatives. To assess the characteristics of the CON-NR tests in the study population, patients were grouped according to the ROME-III criteria as the reference standard for diagnosing constipation. The sensitivity, specificity, and predictive values of each of the simple definitions were determined using the Rome III criteria as the reference standard for chronic constipation and the modified Rome III criteria for subchronic constipation.
Ideally, each value should be close to 100%, which indicates that the definition correctly identifies people with and without constipation according to the reference standard. In conclusion, the ROME-III criteria is currently considered to be the gold standard for diagnosing functional constipation. Physiological tests may also be necessary in order to accurately characterize underlying mechanisms of constipation.