About the Bristol Stool Chart
The Bristol Stool Chart was developed in 1997 as a clinical assessment tool. There are seven types of stools (faeces) according to the Bristol Stool Chart. The Bristol Stool Chart or Bristol Stool Scale is a medical aid designed to classify faeces into seven groups.
Bristol Stool Chart Types
What should my stools look like?
The type of stool or faeces depends on the time it spends in the colon. After you pass faeces, what you see in the toilet bowl is basically the result of your diet, fluids, medications and lifestyle. You can use the Bristol Stool Chart to check what your stools are telling you.
The Bristol Stool Chart shows seven categories of stool. Every person will have different bowel habits, but the important thing is that your stools are soft and easy to pass – like types 3 and 4 below.
Reproduced with kind permission of Dr KW Heaton, formerly Reader in Medicine at the University of Bristol. ©2000-2014, Norgine group of companies.
Reference: Heaton, K W & Lewis, S J 1997, 'Stool form scale as a useful guide to intestinal transit time'. Scandinavian Journal of Gastroenterology, vol.32, no.9, pp.920 - 924. Retrieved on 2/3/2007.
What are the signs of a healthy bowel?
Being ‘regular’ is a way of describing good bowel habits or normal bowel function. We often talk about our bowels being regular but this is often misunderstood as meaning that you go to the toilet to pass faeces every day. It’s common for people to empty their bowel once a day, although it’s still normal to be more or less often. Being regular really means that soft yet well-formed bowel motions are easily passed and that this happens anywhere from 1–3 times a day to 3 times a week.
The bowel usually wants to empty about 30 minutes after a meal (commonly breakfast), but this can vary from person to person.
Good bowel function for adults
There’s more to good bowel function than just being regular. For example, you should be able to:
hold on for a short time after you feel the first urge to go to the toilet
pass a bowel motion within about a minute of sitting down on the toilet
pass a bowel motion easily and without pain – you shouldn’t be straining on the toilet or struggling to pass a bowel motion that is hard and dry
completely empty your bowel when you pass a motion – you don’t have to return to the toilet soon after to pass more.
Bowel control problems
People who pass bowel motions at the wrong time or in the wrong place may be experiencing poor bowel control, or faecal incontinence. They may also pass wind when they don't want to.
Poor bowel control is more common than you think. About 1 in 20 people experience poor bowel control and it affects both men and women. It's more common as you get older, but young people can also have poor bowel control. In some cases, people with poor bowel control also have poor bladder control and may leak urine ().
Good bowel function for children
Children usually develop the ability to be toilet trained by about three years of age. Soiling is when the bowels are emptied in places other than the toilet. Even after a child is toilet trained, there may be occasional accidents with soiling (poo) in your child's underwear.
If a child is unable to be toilet trained or has regular poo accidents after the age of three to four years, then they should be medically assessed. If a child has been toilet trained and at a later stage starts to soil, this also needs medical assessment.
How many children get soiling?
About 1-3% of children can have this problem and some of them may have wetting as well. It is more common in boys.
Soiling may vary from a 'skid mark' to larger amounts that need to be removed from underwear before it can be washed.
Why do children soil?
In almost all cases soiling happens because the large bowel is not emptying properly and the child is constipated. Constipation is very common and occurs at some time in up to 25% of children. If it is not recognised and treated, bowel actions may become harder and less frequent. Over time, stretching of the bowel makes it less sensitive, so the child may not feel when poo needs to come out and therefore has an accident. It is quite possible that there is hard poo inside the bowel, but the soiling is soft runny poo leaking around the hard mass, and so you don't realise that constipation is the underlying problem.
The National Continence Helpline is staffed by continence nurse specialists who offer free and confidential information, advice and support. They also provide a wide range of continence-related resources and referrals to local services.