The document presents an 8-item Constipation Assessment Scale. The scale is used to assess a patient's experience of constipation over the past three days by having them circle whether they had no problem, some problem, or a severe problem with each listed item. The items include abdominal distension, gas passage, bowel movement frequency, stool consistency, rectal fullness, rectal pain, stool size, and inability to pass stool despite urge. Space is provided for the patient's name and date.

1. Source: Palliative Care Nursing- A Guide to Practice, 2003.
733 Dr. Geminer St., Karkafa, Bethlehem –Palestine. P.O. Box: 19960 East Jerusalem 97200
Telefax: 972 2 2767337 , Mobile: 972 522495249 , E-mail: sadeelsoc@yahoo.com

2. Constipation Assessment Scale
Directions: Circle the appropriate number to indicate
whether, during the past three days, you have had No
problem, Some problem or a Severe problem with each
of the items listed.
No Some Severe
Item problem problem problem
1. Abdominal distension or 0 1 2
bloating
2. Change in amount of gas 0 1 2
passed rectally
3. Less frequent bowel 0 1 2
movements
4. Oozing liquid stool 0 1 2
5. Rectal fullness or 0 1 2
pressure
6. Rectal pain with bowel 0 1 2
movement
7. Smaller stool size 0 1 2
8. Urge but inability to pass 0 1 2
stool
Patient’s name Date
Source: Palliative Care Nursing- A Guide to Practice.
733 Dr. Geminer St., Karkafa, Bethlehem –Palestine. P.O. Box: 19960 East Jerusalem 97200
Telefax: 972 2 2767337 , Mobile: 972 522495249 , E-mail: sadeelsoc@yahoo.com