What is the Wexner constipation score?

It is an eight-question constipation score published by Agachan, Wexner and colleagues at Cleveland Clinic Florida in 1996, also called the Cleveland Clinic constipation score. It runs from 0, normal, to 30, severe constipation.

What is a normal constipation score?

The authors defined 0 as normal. There are no validated bands below 15, so a low score is best read against your own earlier scores rather than a cut-off.

What does a constipation score above 15 mean?

In the original 1996 study, all 232 patients referred with constipation scored more than 15. Later studies often use 15 as a cut-off, but the original paper did not test it against people without constipation.

Is the Wexner constipation score the same as the Wexner incontinence score?

No. Both come from Cleveland Clinic Florida, but the incontinence score (0 to 20) rates leakage, while the constipation score (0 to 30) rates frequency, straining, emptying, pain, toilet time, assistance, failed attempts and duration.

Can I use the constipation score if I have IBS-C?

You can use it to track your symptoms, but it was designed for chronic constipation and pain is only one of eight items. In IBS-C, abdominal pain linked to bowel movements is the defining symptom, so a pain-focused score is often more useful alongside it.

How many bowel movements a week counts as constipation?

Rome IV includes fewer than three spontaneous bowel movements a week as one feature of functional constipation, alongside symptoms such as straining, lumpy or hard stools and incomplete emptying. Frequency alone does not define it.

Does a high constipation score mean something is wrong with my pelvic floor?

Not necessarily, but high scores for straining, incomplete emptying, toilet time and needing a finger to help point toward difficulty getting stool out. In the original study, 81 of 232 patients had a pelvic floor muscle that tightened instead of relaxing when they pushed, which tests can check.

Constipation Score Calculator (Cleveland Clinic)

Score your constipation out of 30 with the scale colorectal clinics use.

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Updated October 3, 2026

The short answer

The Cleveland Clinic (Wexner) constipation score adds up eight items: how often you open your bowels, painful straining, feeling of incomplete emptying, abdominal pain, minutes on the toilet per attempt, the help you need (none, stimulant laxatives, or a finger or enema), failed attempts per day and how many years you have been constipated. It runs from 0, normal, to 30, severe. In the original 1996 study, all 232 patients referred with constipation scored more than 15.

How often do you have a bowel movement?The published options leave gaps, for example 3 to 6 times a week. Choose the closest.

How often is passing a stool painful or a strain?

How often do you feel you have not fully emptied your bowel?

How often do you have abdominal (tummy) pain?

How many minutes do you usually spend on the toilet per attempt?

What help do you need to open your bowels?Choose the option that best fits. The original scale lists only these three.

How many unsuccessful attempts to open your bowels do you have per 24 hours?

How many years have you had constipation?

Your previous constipation score, if you know itOptional. Used to show how much your score has changed.

How to use the Constipation Score Calculator

1Choose how often you have a bowel movement.
2Rate how often you have painful straining, a feeling of incomplete emptying and abdominal pain.
3Add your usual toilet time per attempt, the help you need, failed attempts per day and how many years it has been going on.
4Get your total out of 30, how it compares with the original study and the item that contributes most.

How the Cleveland Clinic constipation score is worked out

Agachan, Wexner and colleagues at Cleveland Clinic Florida published the score in 1996. They started from a detailed questionnaire covering more than 100 constipation symptoms, analysed 18 symptom factors and found eight that were statistically significant. Those eight make up the score. It is also called the Wexner constipation score or the constipation scoring system, and it is separate from the Wexner score for bowel incontinence.

Seven items score 0 to 4 and the assistance item scores 0 to 2, for a total from 0 to 30. The widely reproduced version of the table does not define never, rarely, sometimes, usually and always, so answer the same way each time you score.

Item	Options and points	Points
Frequency of bowel movements	1-2 times per 1-2 days 0, 2 times per week 1, once per week 2, less than once per week 3, less than once per month 4	0 to 4
Painful evacuation effort	Never 0, rarely 1, sometimes 2, usually 3, always 4	0 to 4
Feeling of incomplete evacuation	Never 0, rarely 1, sometimes 2, usually 3, always 4	0 to 4
Abdominal pain	Never 0, rarely 1, sometimes 2, usually 3, always 4	0 to 4
Minutes in lavatory per attempt	Less than 5 0, 5-10 1, 10-20 2, 20-30 3, more than 30 4	0 to 4
Type of assistance	Without assistance 0, stimulative laxatives 1, digital assistance or enema 2	0 to 2
Unsuccessful attempts per 24 hours	Never 0, 1-3 1, 3-6 2, 6-9 3, more than 9 4	0 to 4
Duration of constipation (years)	0 0, 1-5 1, 5-10 2, 10-20 3, more than 20 4	0 to 4

What your score means

The authors described 0 as normal and 30 as severe constipation. In their study of 232 people with long-term constipation referred for testing, every patient scored more than 15. Many later papers use 15 as a cut-off for constipation, but the original study did not include people without constipation, so 15 describes where those patients sat rather than a tested dividing line.

There are no validated mild, moderate or severe bands, so this calculator reports your number and how it compares with that original group, and leaves the rest to the trend in your own scores.

Result	What the evidence supports saying
0	Normal, as the authors defined it
1 to 15	Some constipation symptoms; below the scores of the original patient group
16 to 30	In the range every patient in the original 1996 study scored
30	The most severe constipation the scale can record

Constipation, IBS-C and IBD

This score was built for chronic constipation, and abdominal pain is only one of its eight items. In the Rome IV criteria, IBS with constipation is defined by recurring abdominal pain linked to bowel movements, with hard or lumpy stools in more than 25% of bowel movements. Functional constipation is diagnosed only when IBS criteria are not met. If pain is your main problem, the IBS type calculator and our guide to the difference between IBS-D and IBS-C are a better starting point.

Food choices for IBS-C are covered in what to eat with IBS-C. If you have Crohn's disease and constipation rather than diarrhoea, our guide to Crohn's with constipation explains why it happens and when it needs checking.

Frequently asked questions

What is the Wexner constipation score?: It is an eight-question constipation score published by Agachan, Wexner and colleagues at Cleveland Clinic Florida in 1996, also called the Cleveland Clinic constipation score. It runs from 0, normal, to 30, severe constipation.
What is a normal constipation score?: The authors defined 0 as normal. There are no validated bands below 15, so a low score is best read against your own earlier scores rather than a cut-off.
What does a constipation score above 15 mean?: In the original 1996 study, all 232 patients referred with constipation scored more than 15. Later studies often use 15 as a cut-off, but the original paper did not test it against people without constipation.
Is the Wexner constipation score the same as the Wexner incontinence score?: No. Both come from Cleveland Clinic Florida, but the incontinence score (0 to 20) rates leakage, while the constipation score (0 to 30) rates frequency, straining, emptying, pain, toilet time, assistance, failed attempts and duration.
Can I use the constipation score if I have IBS-C?: You can use it to track your symptoms, but it was designed for chronic constipation and pain is only one of eight items. In IBS-C, abdominal pain linked to bowel movements is the defining symptom, so a pain-focused score is often more useful alongside it.
How many bowel movements a week counts as constipation?: Rome IV includes fewer than three spontaneous bowel movements a week as one feature of functional constipation, alongside symptoms such as straining, lumpy or hard stools and incomplete emptying. Frequency alone does not define it.
Does a high constipation score mean something is wrong with my pelvic floor?: Not necessarily, but high scores for straining, incomplete emptying, toilet time and needing a finger to help point toward difficulty getting stool out. In the original study, 81 of 232 patients had a pelvic floor muscle that tightened instead of relaxing when they pushed, which tests can check.

What to Eat With IBS-C: What the Trials Support
What to eat with IBS-C: kiwifruit and soluble fibre have the best record for stools and comfort. Prunes, prune juice and rye bread can work but often cramp.
Difference Between IBS-D and IBS-C Explained
IBS-D and IBS-C are separated by one rule: what share of your abnormal stools are loose versus hard. Here is how the rule works and why the label keeps moving.
Crohn's With Constipation, Not Diarrhea
Constipation is a real Crohn's symptom, not proof of a misdiagnosis. What causes it, when it points at a narrowing, what the activity scores miss, and what to log.
Does Fiber Make IBS Worse? Why Some Types Backfire
Fiber can make IBS worse: bran and fast-fermenting fibers like inulin often do, and even psyllium adds colonic volume. Which type, why, and how to test it.
Feel Like You Need to Poop After You Just Went?
That 'not finished' feeling after a bowel movement is common in IBS. Why it happens, how to tell leftover stool from a false alarm, and what testing can show.

Sources

Agachan F, Chen T, Pfeifer J, Reissman P, Wexner SD. A constipation scoring system to simplify evaluation and management of constipated patients. Dis Colon Rectum. 1996;39(6):681-5. doi:10.1007/BF02056950
Froehner Junior I, Jorge JMN, Marques CFS, Santos VLCG, Jukemura J. Constipation scoring system validated for the Portuguese language (Índice de Gravidade da Constipação Intestinal): is it reliable in assessing the severity of intestinal chronic constipation in our population? Arq Bras Cir Dig. 2023;36:e1785. doi:10.1590/0102-672020230067e1785
Lacy BE, Mearin F, Chang L, Chey WD, Lembo AJ, Simren M, et al. Bowel disorders. Gastroenterology. 2016;150(6):1393-407.e5. doi:10.1053/j.gastro.2016.02.031
Maeda K, Yamana T, Takao Y, Mimura T, Katsuno H, Seki M, et al. Japanese practice guidelines for fecal incontinence part 1: definition, epidemiology, etiology, pathophysiology and causes, risk factors, clinical evaluations, and symptomatic scores and QoL questionnaire for clinical evaluations (English version). J Anus Rectum Colon. 2021;5(1):52-66. doi:10.23922/jarc.2020-057

Cite this tool

Clairop. Constipation Score Calculator. www.clairop.com/tools/constipation-score-calculator. Updated October 3, 2026.

Clairop is a general wellness app for people living with a diagnosed digestive condition. It does not replace professional medical care, diagnosis, or treatment. Always follow your healthcare provider's advice.

Clairop logs meals, symptoms and stool in seconds, then looks for the foods your gut reacts to, including reactions that land days later.

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