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Constipation Severity Scale (CSS)
The instrument is available upon request from: the Rome Foundation
Supplemental: Parkinson's Disease
Short Description of Instrument
The Constipation Severity Scale is an ordinal symptom frequency scale that is calculated as a sum of a 5 –point ordinal frequency ratings for the six Rome III (IV) functional constipation questions (Palsson, Turner et al. 2008, Palsson, Whitehead et al. 2016). The Rome III (IV) CSS is a consistent measure that augments the diagnostic utility of the Rome III (IV) constipation criteria and reflects the degree of quality of life impairment (Palsson, Turner et al. 2008, Palsson, Whitehead et al. 2016).

Frequency ratings: 0=never, 1=sometimes, 2=often, 3=most of the time, 4=always

Psychometric Properties

The Rome III CSS has good internal consistency with a Cronbach alpha of 0.86 and a split-half reliability of r=0.84 (Palsson, Turner et al. 2008).

Palsson OS, Turner MJ, Levy RL, Feld AD, Von Korff M, Drossman DA, Whitehead WE. (2008). The ROME III Questionnaire Functional Constipation Module As a Constipation Severity Scale. Gastroenterology, 134(4 Supplement 1), A421.
Palsson OS, Whitehead WE, van Tilburg MAL, Chang L, Chey W, Crowell MD, Keefer L, Lembo AJ, Parkman HP, Rao SSC, Sperber A, Speigel B, Tack J, Vanner S, Walker LS, Whorwell P, Yang Y. (2016). Development and Validation of the Rome IV Diagnostic Questionnaire for Adults. Gastroenterology 150: 1481-1491.
Other References:
Drossman DA. (2006). Rome III: the new criteria. Chin J Dig Dis 7(4): 181-185.
Drossman DA, Chang L, Bellamy N, Gallo-Torres HE, Lembo A, Mearin F, Norton NJ, Whorwell P. (2011). Severity in irritable bowel syndrome: a Rome Foundation Working Team report. Am J Gastroenterol 106(10): 1749- 1759; quiz 1760.
Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. (2006). Functional bowel disorders. Gastroenterology 130(5): 1480- 1491.


Document last updated February 2018