Bristol Stool Chart: Poop Types and What They Mean

The Bristol Stool Chart is used to determine whether human stool (poop) is typical, or if its shape and consistency suggest a health issue. Healthcare providers use the chart when diagnosing irritable bowel syndrome (IBS) and other gastrointestinal (GI) conditions.

On the Bristol Stool Chart, also called the Meyers Scale, the stool is assigned a number from 1 to 7, from hardest to loosest. Normal stools are those in the middle of the chart, in the 3 to 4 range.

What Is the Bristol Stool Chart?

The Bristol Stool Chart is used when a healthcare provider is diagnosing the cause of constipation, diarrhea, or other symptoms. They typically ask you to look at the chart and point to the number that most closely matches the look and form of your bowel movements:

• Type 1: Separate hard lumps (hard to pass)
• Type 2: Lumpy, hard, sausage-shaped
• Type 3: Sausage-shaped with cracks on the surface
• Type 4: Sausage-shaped or snake-like; smooth and soft
• Type 5: Soft blobs with clear-cut edges (easy to pass)
• Type 6: Fluffy pieces with ragged edges; mushy
• Type 7: Entirely liquid, watery, no solid pieces
  

Hard Stools: Types 1 and 2

Types 1 and 2 describe stool that is hard to pass and may point to constipation. Stools of these types may be darker in color than normal stools. Constipation causes include:

• A low-fiber diet and inadequate fluid
• GI conditions such as IBS
• Health issues like Parkinson's disease
• Side effects from certain medications

Bloating and stomach pains may go along with these types. Stools that are hard to pass can cause you to strain when trying to have a bowel movement and lead to diverticulosis and hemorrhoids. In some cases, you may see blood in the stool with these conditions.

Healthy Stool: Types 3 and 4

Types 3 and 4 describe stool that is well-formed and easy to pass. These are thought of as "normal," healthy stools and the most ideal.

Loose Stools: Types 5 and 6

Type 5 stools are considered borderline diarrhea. For some people, they may be typical even in the absence of a GI condition. For others, they may suggest a mild or developing GI issue. They also can indicate a dietary problem such as inadequate fiber intake.

Diarrhea can be considered:

• Acute when it lasts 14 day or less, as with an infection
• Persistent, when it's between 14 and 30 days
• Chronic, when it lasts more than 30 days

Type 6 stools are considered diarrhea even though they are not liquid. Diarrhea is often caused by a viral or bacterial infection, though it can also be a medication side effect or a symptom of a medical condition such as IBD or IBS.

Diarrhea: Type 7

Type 7 describes very loose stools or fully liquid diarrhea. With this type, you may feel an urgent need to have a bowel movement and may not be able to hold it. If the diarrhea persists, you may also become dehydrated or malnourished.

This type of diarrhea is most often caused by a viral or bacterial infection such as norovirus. Parasitic infections such as Giardia lamblia can cause watery diarrhea. Certain medical conditions can cause type 7 stools as well, including celiac disease, Crohn's disease, or ulcerative colitis.  

How the Bristol Stool Chart Is Used

Your healthcare provider may use the Bristol Stool Chart if you have unusual bowel symptoms or notice a change in your bowel habits or the way your stools look.

These include issues such as:

• Diarrhea
• Constipation
• Switching between diarrhea and constipation
• Abdominal cramps
• Bloating and gas
• Nausea or fullness
• Steatorrhea ("greasy" floating stool)
• Other symptoms that point to malabsorption, or an inability to digest and absorb nutrients

Your healthcare provider may ask you to look at your stool and compare it to the Bristol Stool Chart. You can then talk about any changes to your bowel habits and the new score at your next visit.

During your visit, your healthcare provider may:

• Ask how often you tend to have a bowel movement and whether you have been having them more or less often than usual
• Ask about odor, quantity of poop, blood or mucus, and whether stool flushes easily.
• Look at a sample of your stool and order tests such as a stool culture for bacteria
• Use the Rome Criteria to see if your symptoms match those of a functional gastrointestinal disorder such as IBS

A modified version of the chart can also be used for children. It includes drawings that children can use to describe their stools when being assessed for bowel issues such as constipation and soiling.

What Do Different Poop Colors Mean?

Brown is typically the healthiest color for poop. Some color changes can occur with diet or medication, but they also can signify a problem. These can include:

• Green poop: This can occur with foods you eat, or if you take antibiotics. It also can suggest an infection or a digestive disorder.
• Yellow poop: This can be related to diet but is normal in breastfeeding babies.
• Orange poop: Foods can cause poop to be orange, but it's a common sign of malabsorption.
• Black poop: This can happen with medications or with foods like blueberries. But it also is a warning sign of bleeding somewhere in the upper digestive tract.
• Red poop: Bright red color in the stool is a warning sign of bleeding in the lower digestive tract, although it can be due to certain red-colored foods.

You should notify your healthcare provider immediately if you suspect blood in your stool. You also should let them know if pale chalky stools common to pancreatitis have occurred.

Factors That Can Influence Bowel Habits

A person's bowel habits are influenced by many factors and can change day to day.

For instance, your bowel habits may shift due to:

• Diet
• Stress
• Travel
• Dehydration
• Medicines
• Changes that occur as you age
• How active you are or how much you exercise
• Illness such as the stomach flu
• Changes in your hormone levels, such as those that occur when you are pregnant or menstruate
• More serious health issues such as inflammatory bowel disease or colon cancer

Signs of Healthy Bowel Movements

The Bristol Stool Chart identifies types 3 and 4 as samples of healthy stools. They are well-formed in their consistency and shape, and neither too hard nor too loose.

Signs of bowel health include:

• Moving your bowels without straining or difficulty
• No pain associated with bowel movements
• No blood or chalky, pale color to the stool (brown is best)
• Pooping daily (or regularly), neither too often nor too little
• Not feeling as if your bowel movement was incomplete
  

Floating stool can be considered normal and may be due to diet. It also may be linked to health conditions including malabsorption, infection, pancreatitis, and IBS. Talk to your healthcare provider about symptoms.

Improving Bowel Health

Bowel health is closely related to diet and exercise. Often, simple changes like drinking more fluids, eating a diet high in fiber, and exercising regularly will help you achieve easy-to-pass stools. You can:

• Avoid fatty foods, alcohol, and caffeine if they are causing difficulty.
• Talk to your healthcare provider about new medications that led to changes,
• Train your body to have a bowel movement on a regular schedule,
• Sit correctly on the toilet, straight or leaning forward. It may also help to keep your knees higher than your hips.
• Try breathing techniques while moving bowels.
  

Summary

The Bristol Stool Chart is a tool used by your healthcare provider to assess your stool. The 7-point scale helps describe your stool shape and consistency. Based on the results, your provider can assess your bowel patterns and habits and order more tests as needed to figure out what may be causing your GI issues.

The scale is also used as a research tool to explore GI disorders and how well various treatments work for these issues.