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Bristol Stool Chart Cheat Sheet by

Classifying stool
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Type 1: Separate hard lumps, like nuts

Typical for acute dysbac­ter­iosis. These stools lack a normal amorphous quality, because bacteria are missing and there is nothing to retain water. The lumps are hard and abrasive, the typical diameter ranges from 1 to 2 cm (0.4–0.8”), and they‘re painful to pass, because the lumps are hard and scratchy. There is a high likelihood of anorectal bleeding from mechanical laceration of the anal canal. Typical for post-a­nti­biotic treatments and for people attempting fiber-free (low-carb) diets. Flatulence isn‘t likely, because fermen­tation of fiber isn‘t taking place.

Type 2: Sausag­e-like but lumpy

Represents a combin­ation of Type 1 stools impacted into a single mass and lumped together by fiber components and some bacteria. Typical for organic consti­pation. The diameter is 3 to 4 cm (1.2–1.6”). This type is the most destru­ctive by far because its size is near or exceeds the maximum opening of the anal canal‘s aperture (3.5 cm). It‘s bound to cause extreme straining during elimin­ation, and most likely to cause anal canal lacera­tion, hemorr­hoidal prolapse, or divert­icu­losis. To attain this form, the stools must be in the colon for at least several weeks instead of the normal 72 hours. Anorectal pain, hemorr­hoidal disease, anal fissures, withho­lding or delaying of defeca­tion, and a history of chronic consti­pation are the most likely causes. Minor flatulence is probable. A person experi­encing these stools is most likely to suffer from irritable bowel syndrome because of continuous pressure of large stools on the intestinal walls. The possib­ility of obstru­ction of the small intestine is high, because the large intestine is filled to capacity with stools. Adding supple­mental fiber to expel these stools is dangerous, because the expanded fiber has no place to go, and may cause hernia, obstru­ction, or perfor­ation of the small and large intestine alike.

Type 3: Like a sausage but w/cracks in the surface

This form has all of the charac­ter­istics of Type 2 stools, but the transit time is faster, between one and two weeks. Typical for latent consti­pation. The diameter is 2 to 3.5 cm (0.8–1.4”). Irritable bowel syndrome is likely. Flatulence is minor, because of dysbac­ter­iosis. The fact that it hasn‘t became as enlarged as Type 2 suggests that the defeca­tions are regular. Straining is required. All of the adverse effects typical for Type 2 stools are likely for type 3, especially the rapid deteri­oration of hemorr­hoidal disease.

BSF Chart

Type 4: Like a sausage or snake, smooth & soft

This form is normal for someone defecating once daily. The diameter is 1 to 2 cm (0.4–0.8”). The larger diameter suggests a longer transit time or a large amount of dietary fiber in the diet.

Type 5: Soft blobs with clear-cut edges

I consider this form ideal. It is typical for a person who has stools twice or three times daily, after major meals. The diameter is 1 to 1.5 cm (0.4–0.6”).

Type 6: Fluffy pieces w/ragged edges, mushy stool

This form is close to the margins of comfort in several respects. First, it may be difficult to control the urge, especially when you don‘t have immediate access to a bathroom. Second, it is a rather messy affair to manage with toilet paper alone, unless you have access to a flexible shower or bidet. Otherwise, I consider it borderline normal. These kind of stools may suggest a slightly hypera­ctive colon (fast motility), excess dietary potassium, or sudden dehydr­ation or spike in blood pressure related to stress (both cause the rapid release of water and potassium from blood plasma into the intestinal cavity). It can also indicate a hypers­ens­itive person­ality prone to stress, too many spices, drinking water with a high mineral content, or the use of osmotic (mineral salts) laxatives.

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