World Gastroenterology Organisation

Global Guardian of Digestive Health. Serving the World.


WGO Practice Guideline



Constipation is a symptom, not a disease.

The patient's view. Different patients have different perceptions of symptoms. Some patients regard constipation as straining (52%), while for others, it means hard, pellet-like stools (44%) or an inability to defecate when desired (34%), or infrequent defecation (33%).

The clinical view. There is constipation if patients who do not take laxatives report at least two of the following in any 12-week period during the previous 12 months (the Rome Criteria):

  • Fewer than three bowel movements (BMs) per week
  • Hard stool in more than 25% of BMs
  • A sense of incomplete evacuation in more than 25% of BMs
  • Excessive straining in more than 25% of BMs
  • A need for digital manipulation to facilitate evacuation

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Review Team

  • Greger Lindberg (Chair, Sweden)
  • Saeed Hamid (Pakistan)
  • Peter Malfertheiner (Germany)
  • Ole Thomsen (Denmark)
  • Luis Bustos Fernandez (Argentina)
  • James Garisch (South Africa)
  • Alan Thomson (Canada)
  • Khean-Lee Goh (Malaysia)
  • Rakesh Tandon (India)
  • Suliman Fedail (Sudan)
  • Benjamin Wong (China)
  • Aamir Khan (Pakistan)
  • Justus Krabshuis (France)
  • Anton Le Mair (The Netherlands)

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