40 目前根據最新的Rome criteria III來診斷腸躁症（irritable bowel syndrome），必須符合兩個或兩個以上的敍述，下列何者不是Rome criteria III？
(A) Straining during at least 25% of defecation
(B) Fewer than one defecation per week
(C) Sensation of incomplete evacuation for at least 25% of defecations
(D) Manual maneuvers to facilitate at least 50% of defecations
(E) Lumpy or hard stools in at least 25% of defecations