Traditionally, physicians have defined constipation as three or fewer bowel movements per week. Having fewer bowel movements is associated with symptoms of lower abdominal discomfort, distension, or bloating.10 However, patients tend to define constipation differently than physicians, and describe it in a variety of ways. In a self-reported survey
of 1,028 young adults, 52 percent defined constipation as straining, 44 percent as hard stools, 32 percent as infrequent stools, and 20 percent as abdominal discomfort.11 The Rome III diagnostic criteria are widely used in research and provide a more complete and reproducible definition of functional constipation (Table 1).12 Frequency of bowel movements is only one of the criteria.