• Emily Reul, PT, DPT

The Bristol Stool Chart

Hi friends! This week we are going to talk about poop. Have you ever noticed that your poop doesn’t always look the same everytime you go? Some days it may look like a log while other days it looks like rabbit pellets, or maybe it is very loose and watery. The look of your poop can actually tell us a lot about your bowel and pelvic floor function! There are several different measurement scales that can be used to describe poop types, but the Bristol Stool Form Scale is one of the most widely used (Blake, 2016) by pelvic floor physical therapists and other healthcare providers.



The Bristol Stool Scale uses a scale from 1-7 to classify poop. Type 1 poop is small, hard lumps (like nuts) that are often hard to pass. The scale slowly progresses in consistency to type 7 which is watery stool with no solid pieces.

Typically, the faster your stool travels through your digestive tract, it will have more water in it and be closer to a type 7 (Blake, 2016). The longer stool stays in your system, your body has more time to absorb water and your poop will be more firm. Hard poop is usually harder to pass through. Individuals with constipation often have stools closer to type 1. Ideally, healthy poop will be types 3, 4, or 5 (Blake, 2016). Without using the scale, a good comparison of healthy poop is the consistency of a ripe banana.


The Bristol Stool Scale can be a helpful tool to help describe your poop when keeping a bladder diary or when discussing your symptoms with a healthcare provider.


So how does my poop impact my pelvic floor? Your pelvic floor muscles need to be strong enough to keep poop in and have the ability to relax to let the poop out when you are ready to go. Having liquid stool (closer to a type 7) can make it harder for weak pelvic floor muscles to keep poop in. Think about the last time you had diarrhea, when you get the urge to go you usually want to get to the bathroom ASAP! One the opposite end, when you’re constipated it can be difficult for the pelvic floor muscles to fully relax to let the stool pass through. Straining to have a bowel movement can be a risk factor for developing pelvic organ prolapse, hemorrhoids, and other conditions.



Healthy toileting habits are one way to help prevent pelvic floor muscle dysfunction. A squatty potty is a great tool to help you pass poop easier. The squatty potty puts your pelvic floor muscles in the best position to relax and let poop come out no matter what the consistency is. Check out these six common poop mistakes and ways to fix them!



Your poop can even affect your bladder and urgency/leakage symptoms! If you are constipated, you may find that you need to pee more often or you have more leakage. The bladder and rectum can influence the way each other function because they sit very close to one another on the pelvic floor. Products like flax seed or fiber supplements can be helpful to move stool throughout the digestive tract for healthy poop. You can also perform an abdominal bowel massage to stimulate the movement of poop along your colon if you are constipated.



If you are consistently having issues with pooping or any urinary symptoms, you should seek the help of a healthcare provider. A pelvic floor physical therapist is a great resource and in many states you can see a physical therapist without a referral from a physician.


Here are some great resources to learn more about your pelvic floor good pooping habits:

  • Ask your healthcare provider for a referral to a pelvic therapist.

  • Find a pelvic therapist on your own at myPFM.com. We have links to 4 free searchable databases under Find a PT.

  • Watch our YouTube video Irritable Bowel Syndrome with Dr. Kumkum Patel, MD, MPH

  • Learn more about the pelvic floor muscles with our book: My Pelvic Floor Muscles The Basics

  • Sign up for our email newsletter!

  • Watch a quick video to learn about your pelvic floor.


For providers, check our online courses to help your clients experiencing bowel dysfunction. Consider joining our Ambassador Program and most of our courses are included with your membership!

What experiences or tips do you have that can help others? We’d love to hear them. Please join the conversation in the comments section below.  


Written by Emily Reul, PT, DPT

References

1. Lewis SJ, Heaton KW. Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol. 1997;32(9):920-924.

2. Blake MR, Raker JM, Whelan K. Validity and reliability of the Bristol Stool Form Scale in healthy adults and patients with diarrhoae-predominant irritable bowel syndrome. Aliment Pharmacol Ther. 2016;44(4):693-703.

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This information is for awareness purposes and not individual medical advice. You should seek your own professional counsel for any medical condition or before starting or altering any exercise or fitness program.

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