Table 1, Key components of history-taking to diagnose constipation - Constipation in children and young people: diagnosis and management

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Key components	Potential findings in a child younger than 1 year	Potential findings in a child/young person older than 1 year
Stool patterns	Fewer than three complete stools per week (type 3 or 4, see Bristol Stool Form Scale - appendix B) (this does not apply to exclusively breastfed babies after 6 weeks of age) Hard large stool ‘Rabbit droppings’ (type 1, see Bristol Stool Form Scale - appendix B)	Fewer than three complete stools per week (type 3 or 4, see Bristol Stool Form Scale - appendix B) Overflow soiling (commonly very loose [no form], very smelly [smells more unpleasant than normal stools], stool passed without sensation. Can also be thick and sticky or dry and flaky.) ‘Rabbit droppings’ (type 1, see Bristol Stool Form Scale - appendix B) Large, infrequent stools that can block the toilet
Symptoms associated with defecation	Distress on stooling Bleeding associated with hard stool Straining	Poor appetite that improves with passage of large stool Waxing and waning of abdominal pain with passage of stool Evidence of retentive posturing: typical straight legged, tiptoed, back arching posture Straining Anal pain
History	Previous episode(s) of constipation Previous or current anal fissure	Previous episode(s) of constipation Previous or current anal fissure Painful bowel movements and bleeding associated with hard stools

Constipation in children and young people: diagnosis and management.

NICE Clinical Guidelines, No. 99.

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