The diagnosis of a Functional Disorder of the Anus and Rectum always presumes the absence of a structural or biochemical explanation for the symptoms.
F1. Functional Fecal Incontinence
Recurrent uncontrolled passage of fecal material for at least one month, in an individual with a developmental age of at least 4 years, associated with:
- Fecal impaction; or
- Diarrhea; or
- Nonstructural anal sphincter dysfunction.
F2. Functional Anorectal Pain
F2a. Levator Ani Syndrome
At least 12 weeks, which need not be consecutive, in the preceding 12 months of:
- Chronic or recurrent rectal pain or aching;
- Episodes last 20 minutes or longer; and
- Other causes of rectal pain such as ischemia, inflammatory bowel disease, cryptitis, intramuscular abscess, fissure, hemorrhoids, prostatitis, and solitary rectal ulcer have been excluded.
F2b. Proctalgia Fugax
- Recurrent episodes of pain localized to the anus or lower rectum;
- Episodes last from seconds to minutes; and
- There is no anorectal pain between episodes.
F3. Pelvic Floor Dyssynergia
- The patient must satisfy diagnostic criteria for functional constipation in Diagnostic Criteria C3;
- There must be manometric, EMG, or radiologic evidence for inappropriate contraction or failure to relax the pelvic floor muscles during repeated at-tempts to defecate;
- There must be evidence of adequate propulsive forces during attempts to defecate, and
- There must be evidence of incomplete evacuation.
Douglas A. Drossman. ROME II: The Functional Gastrointestinal Disorders, Second Edition
This material was taken from the ROME II. It is intended for educational purposes only.
Created: Mar 19, 2005