Stool Diary: the Bristol Stool Scale

One of the best ways for you and your doctors to gain a better understanding of your symptoms/illness is to keep a stool diary, which involves making notes regarding different aspects of your toilet habits.

Your doctor will ask you to keep a record of stool frequency, volume, whether you strained during the bowel movement or felt like you had not fully emptied your bowel at the end, and to describe the stool itself using the Bristol stool scale, shown below.

How your stool compares to these different types can be a good indicator of your general bowel health.

  • Stool types 1 and 2 are an indication of constipation
  • Stool types 3 and 4 are considered to be ‘normal’
  • Stool types 5, 6, and 7 indicate progressive forms of diarrhoea

Stool Colour

It is also important to observe the colour of your stool.

  • The presence of bright red blood is an indication of an anal fissure (a common side effect of constipation) or haemorrhoids.
  • Dark red or black stools may be sign of something more serious, such as an ulcer or intestinal bleeding
  • Pale yellow greasy stools could indicate pancreatic diseases

The records kept in your stool diary can help your doctor understand your symptoms, and by identifying any patterns can both diagnose the problem, and identify potential triggers for your disease. In some cases it may be necessary to also provide a sample of your stool for testing in a specialised laboratory. This can help to identify other potential conditions such as inflammation, or infection with bacteria or parasites.

Based on your symptoms, your doctor may want to send you for further testing, most commonly to have a direct look into your digestive system using techniques such as endoscopy, colonoscopy and sigmoidoscopy.

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