What is the Bristol Stool Chart and what does it mean?
With so many bowel conditions and variations, researchers needed a way to come up with a standardized test to determine what each person’s bowel motions actually looked like and what this may mean clinically. As everyone has their own subjective view on their types and patterns of poop. The scale is used by clinicians, researchers, and the public alike.
Stool formation tells you a lot about your intestinal transit time and the scale is largely associated with stool water content e.g. the more water in your stool, the faster the transit time. This is because water is absorbed in your large intestine, so the quicker it goes through, the less time you have to absorb that water. (Blake et al., 2016).
Here is the BSC
Hard Stools (Types 1-2) (Blake et al., 2016)
Type 1 and 2 are considered constipation (Amarenco, 2014). Constipation is often accompanied by other symptoms such as bloating, incomplete evacuation, hard to pass stools, abdominal discomfort, excessive straining, and infrequent bowel movements (Costilla & Foxx-Orenstein, 2014). Type 2 is an indication of a lack of hydration but can also be a sign that your bowel transit time is slowing down (if you have not already, check out my post on what a healthy bowel movement is HERE).
Now the odd occasion of this may not indicate anything sinister, however, it may indicate a lack of:
And may be contributed to by:
- Liver and gall bladder insufficiencies
What to do about it?
So, you notice you have type 1 bowel movements consistently for a week, home management may include increasing water, increasing fiber, changing the way you sit on the toilet (including a footstool when using the toilet (Costilla & Foxx-Orenstein, 2014)), prunes or increasing fruit intake. If it continues to persist – a doctor’s visit may be needed (see my post about bowel cancer HERE).
“Normal” (Types 3–5) (Blake et al., 2016)
Type 3 and 4 are your most common form of bowel movement, ok, maybe not common, but thought to suggest a healthy bowel. While type 5 is considered normal, it does suggest a lack of fiber or stimulant use, such as coffee.
Loose stools (Types 6–7)”(Blake et al., 2016)
Consistent loose stools can indicate suggests lack of fiber, viral infection, food poisoning, increased intestinal transit time or food sensitivities, a viral infection (such as norovirus), food poisoning, increased intestinal transit time, or food allergies. Chronic diarrhea (ongoing loose stools over a period of time), which is associated with many conditions, such as IBS, dairy/food intolerances, celiac disease, Crohn’s disease, intestinal giardiasis, colorectal cancer, and diverticulosis. Other conditions impact the gastrointestinal tract such as liver cirrhosis, coronary disease, medications such as NSAID or aspirin use, and renal insufficiency (Carroccio et al., 2003).
What to do about it?
You notice you have type 5/6 bowel movements consistently for a week. Home management may include increasing fiber, decreasing stimulants (like coffee). If it continues to persist – a visit to your local naturopath is in order to get a comprehensive check-up or click HERE to book in with me.
Bowel movements come in different shapes and consistencies, this is largely determined by your intestinal transit time and how much water is being absorbed through your large intestine. With bowel movements, it’s not just the once-off that counts – unless you have type 7 for over 24 hours (go see your doctor!), it’s the pattern that counts. I have a bowel movement diary available for download HERE, so you can see what your pattern is.
If you would like to visit a naturopath to talk about your bowel habits, click HERE to book in with me.
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Amarenco, G. (2014). Bristol Stool Chart : étude prospective et monocentrique de « l’introspection fécale » chez des sujets volontaires. Progrès En Urologie, 24(11), 708–713. https://doi.org/10.1016/j.purol.2014.06.008
Blake, M. R., Raker, J. M., & Whelan, K. (2016). Validity and reliability of the Bristol Stool Form Scale in healthy adults and patients with diarrhoea-predominant irritable bowel syndrome. Alimentary Pharmacology & Therapeutics, 44(7), 693–703. https://doi.org/10.1111/apt.13746
Carroccio, A., Iacono, G., Cottone, M., Di Prima, L., Cartabellotta, F., Cavataio, F., Scalici, C., Montalto, G., Di Fede, G., Rini, G., Notarbartolo, A., & Averna, M. R. (2003). Diagnostic Accuracy of Fecal Calprotectin Assay in Distinguishing Organic Causes of Chronic Diarrhea from Irritable Bowel Syndrome: A Prospective Study in Adults and Children. Clinical Chemistry, 49(6), 861–867. https://doi.org/10.1373/49.6.861
Costilla, V. C., & Foxx-Orenstein, A. E. (2014). Constipation in Adults: Diagnosis and Management. Current Treatment Options in Gastroenterology, 12(3), 310–321. https://doi.org/10.1007/s11938-014-0025-8
Lewis SJ, Heaton KW (1997) Stool form scale as a useful guide to intestinal
transit time. Scandinavian Journal of Gastroenterology 32: 920–4