Bristol stool scale

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Bristol stool chart

The Bristol stool scale, Bristol stool chart (BSC),[1] Bristol stool form scale, or BSF scale[2] is a medical aid designed to classify the form of human feces into seven categories. Sometimes referred to in the UK as the Meyers scale,[3] it was developed by Dr. Stephen Lewis and Dr. Ken Heaton at the University of Bristol and was first published in the Scandinavian Journal of Gastroenterology in 1997.[4] The authors of that paper concluded that the form of the stool is a useful surrogate measure of colon transit time. That conclusion has since been challenged as having limited validity, and only in types 1 and 2 when the subject is not constipated.[5] However, it remains in use as a research tool to evaluate the effectiveness of treatments for various diseases of the bowel, as well as a clinical communication aid.[6][7]

The Bristol stool scale is part of the diagnostic triad for irritable bowel syndrome: pain/discomfort (quality and quantity); bowel habit (quality and quantity); and bloating (in women).[8]

The seven types of stool are:

  • Type 1: Separate hard lumps, like nuts (hard to pass)
  • Type 2: Sausage-shaped, but lumpy
  • Type 3: Like a sausage but with cracks on its surface
  • Type 4: Like a sausage or snake, smooth and soft
  • Type 5: Soft blobs with clear cut edges (passed easily)
  • Type 6: Fluffy pieces with ragged edges, a mushy stool
  • Type 7: Watery, no solid pieces, entirely liquid

Types 1 and 2 indicate constipation, with 3 and 4 being the ideal stools (especially the latter), as they are easy to defecate while not containing excess liquid, and 5, 6 and 7 tending towards diarrhoea.

References

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  2. Gut Sense What Exactly Are Normal Stools?, Konstantin Monastyrsky. Accessed July 2015
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  7. Bristol scale stool form. A still valid help in medical practice and clinical research G Riegler, I Esposito – Techniques in coloproctology, 2001 – Springer
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