The Rome IV criteria were released in May 2016. Based on the development of brain-intestinal axis theory, intestinal microecology, pharmacogenomics and social psychology, the RomeⅣ criteria revise the definition, diagnostic criteria, clinical evaluation process, and treatments of functional constipation (FC) . The revisions are as follows: (1) Definition: FC and constipation-predominant irritable bowel syndrome are considered to be on a continuum rather than as independent entities. (2) Diagnostic criteria: the Bristol stool scale type 1, type 2 and spontaneous bowel movements are added in the diagnostic criteria, respectively, refining the criteria for stool consistency and frequency. (3) Clinical evaluation process: the RomeⅣ criteria specifies the clinical assessment procedure for FC. The aim is to exclude organic disease, to detect the structural changes of the combination, to determine the type of guidance therapy, and to reduce unnecessary checks to improve diagnostic efficiency. (4) Pathophysiologic mechanism: much more newly investigated mechanisms are added, including the risk factors, genetics, inadequate colonic propulsion and defecation disorder. (5) Treatment: the treatment regimen summarizes the evidence-based medical evidence of new drugs, such as secretagogues and bile acid transport inhibitors, and evaluates the safety of all the new and old drugs. Compared to the Rome Ⅲ standard, the diagnosis of FC will be more stringent and efficient, and the treatment options will be more standardized and reasonable with the Rome Ⅳ.

Functional constipation; RomeⅣ criteria; Update