Table of contents:
Is that such a thing as the perfect poop?
Why do I care about what my poop looks like?
Which is better? The shape of my poop, or how often I have a bowel movement?
The free screen: The Bristol Stool Form Scale. (adults and kids)
What is the "perfect poop" according to the Bristol Stool Form Scale?
How can I improve my stool form?
1. Is there such a thing as the perfect poop?
I know what the perfect poop is not!
The perfect poop is not the one that grabs your attention, or the one that slows you down, or the one that bugs you when you are busy.
Maybe the perfect poop is the one we never think about or are aware of?
The one that slips out quickly after our morning coffee and lets us go about our day.
In this article, we look at the stuff floating in the water after you have done your thing. You know, when you usually get up, turn around and evaluate your art piece.
This article is written for you when you start asking the question of what exactly is the perfect poop anyway?
2. Why do I care what my poop looks like?
We encourage you to care.
Looking at the shape of our poop can be used as a quick screen to help you decide if you need help with your bowel health. Medical professionals include the shape of stool in their assessment, and the scale they use is free!!
We also care about the shape of our poop because when poop slides out easily, we don't strain, and when we don't strain, we don't cause issues such as hemorrhoids, diverticula, pelvic floor dysfunction, and other fun back passage problems.
Most people look at how often they go to evaluate their bowel health. So, let's first look at bowel frequency as a measure of bowel health.
3. Which is better? The shape of my poop or how often I have a bowel movement?
Stool form is a better measure of slow bowel transit time (when it takes food to move from the mouth to the rectum) than how often we have a bowel movement.
In 2009, Saad et al. 1 examined stool form and frequency to measure transit time in constipated and healthy adults.
The researchers discovered stool frequency (how frequently you go) is not a reliable clinical measure of transit time in constipated and healthy adults.
They found that stool form (what your poop looks like) can be used to predict transit time, especially in constipated adults, but it cannot determine the severity of slow transit time.
So, let's look at the form of our poop instead of frequency to help us decide if we should maybe give our doc a call for that overdue physical.
(Please note that this article is for informational purposes only and should not be considered medical advice. If you have any health concerns, please consult your doctor.)
4. The Free Screen: The Bristol Stool Form Scale:
The Bristol Stool Form Scale 2 is a free stool evaluation tool for our bowel health. (Developed by Dr K.W. Heaton)
Using numbers can make the poop conversation with others, like our doctors or pelvic floor therapist, a lot more comfortable.
In our pelvic floor clinic, we can use these numbers to track your dietary progress or to fully understand your current stool situation.
Many children suffer from constipation, and we use the adapted Bristol Scale to teach them about bowel health. Hey, this one is so cute. I used it with the adults, too.
A pediatric version 3 was developed for treating kids suffering from constipation.
They described each stool form in a more fun manner, such as rabbit droppings for Type 1 and chicken nuggets for Type 6.
Type 1: Separate, pellet-like hard lumps that are hard to pass (rabbit droppings) Considered high on the constipation scale.
Type 2: Lumpy, sausage-shaped stool (a bunch of grapes) Considered slightly constipated.
Type 3: Sausage-shaped stool with cracks on the surface (corn on the cob) Considered normal.
Type 4: Sausage-shaped stool but smooth and soft (sausage). Considered normal.
Type 5: Blobs that are soft and pass easily (chicken nuggets) Considered lacking fiber.
Type 6: Mushy stool in the form of fluffy pieces and ragged edges (porridge). Considered inflammation present.
Type 7: Entirely liquid; no solid pieces (gravy). Considered inflammation and diarrhea.
Other methods to teach kids:
In our pelvic physical therapy clinic, we may also have the kids use food pictures to describe the different stool types.
We also use several excellent poop books available to purchase on Amazon to teach kids about bowel health and the shape of their poop.
Two of my favorite books to teach children about poop forms are:
The Poos You'll Do: Meet Mr. Poofect & Friends. Paperback – June 1, 2021 by Gina Phillip and David Wykes
The Science Behind Different Types of Poop: A Funny Science Book About Pooping (Funny STEAM) Paperback – March 26, 2021 by Science Kids University
6. What is the "perfect poop" according to the Bristol Stool Form Scale?
Please aim for Type 3 or 4, a stool that is easy to pass and well-formed.
But to shoot for the "perfect poop" can be stressful, and our bowels do not operate well under stress. Also, changing our stool form can be slow, and we must be patient.
Pro-tip from a pelvic floor therapist for adults:
In our pelvic floor physical therapy clinic, I find that many adults with bowel problems, such as constipation, experience anxiety when they are unable to produce the recommended stool form. Many report that they have a hard time moving beyond Bristol Stool Type 1 or 2.
Our advice to adults struggling with constipation is that it is ok to hang out where you are while you are working on producing a better poop form. The main thing during this time is to avoid straining.
Pro-tip from a pelvic floor therapist for kids:
Children suffering from constipation usually need the help of medication and need to work with their doctor and pelvic floor therapist.
Childhood constipation can lead to urinary leakage, fecal incontinence, and bed wetting.
Some children outgrow their problems, but many do not, and their issues can continue into adulthood.
Recommendations for adults and kids:
Read our sister article in this series, "It Takes Two To Poop." In the first article, we look at partnering up with your body when performing bodily functions, using a toilet footstool, and the best toileting position.
If you have problems, we suggest you meet with your favorite pelvic floor therapist to ensure you use your muscles correctly during bowel movements.
We recommend using the free evaluation screen, the Bristol Stool Scale, to evaluate your bowel health. If you suspect a problem, you can use this starter information to see your doctor, but please this scale is just a measure of what your poop looks like and is not information to be used to self-diagnose.
7. How can I improve my stool form?
Some strategies to produce a more slippery, sleek product may include drinking more water, exercising, moving more during your day, taking medication, improving your diet, adding fiber, and giving yourself a belly massage.
Summary:
Looking at the shape of our poop and using the Bristol Stool Chart Scale can be a helpful habit to monitor our bowel health.
We now know that what our stool looks like is more important than the frequency of our bowel movements when considering transit time.
We can also use an adapted Bristol Stool Scale for children. In our pelvic floor clinic, we also utilize children's books and food pictures to teach kids suffering from constipation about stool form.
As a pro-tip, we suggest that while adults with constipation work on producing a perfect poop, they are ok having a Bristol Stool Scale Type 1 as long as they do not strain during a bowel movement.
Children suffering from constipation should work with their doctor and pelvic floor therapist and will most likely need to take additional medication.
(Please note that this article is the second in a series we call "It Takes Two To Poop" The first article discusses how to work with your body and how to use a toilet footstool.)
References:
Saad, Richard J., et al. "Do stool form and frequency correlate with whole-gut and colonic transit? Results from a multicenter study in constipated individuals and healthy controls." Official journal of the American College of Gastroenterology| ACG 105.2 (2010): 403-411.
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.
https://pediatricsurgery.stanford.edu/Conditions/BowelManagement/bristol-stool-form-scale.html
About the author:
Dr. Sunel Vanderwalt owns Trailhead Pelvic & Visceral Physical Therapy in Albuquerque, NM, where she provides pelvic floor therapy for adults and kids.
She combines orthopedic, pelvic, visceral manipulation, and manual physical therapy.
The content on this site is provided for informational purposes only and should not be used as a substitute for direct medical advice from your doctor or another qualified clinician.
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