Must include at least two of the following*:

Straining during more than 25% of defecations

Lumpy or hard stools (Bristol Stool Form Scale type 1 or 2) in more than 25% of defecations

Sensation of incomplete evacuation in more than 25% of defecations

Sensation of anorectal obstruction or blockage in more than 25% of defecations

Manual maneuvers needed to facilitate more than 25% of defecations

Fewer than three spontaneous bowel movements per week

Loose stools are rarely present without laxatives

Criteria for irritable bowel syndrome are insufficient