Bristol Stool Scale

Bristol Stool Scale
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Classifying the fecal form of omnivores, vegetarians, and vegans.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Last year, the University of Bristol celebrated their 100-year anniversary. Prestigious institution of higher learning. Produced nine Nobel laureates and the Bristol Stool Scale, a medical tool used to classify the fecal form. Seven different classifications: 

Type 1: Looks like rabbit droppings. Separate hard lumps, like nuts; hard to pass.
Type 2: Looks like a bunch of grapes. Sausage-shaped, but lumpy.
Type 3: Looks like corn on the cob.
Type 4: Like a sausage or snake, smooth and soft.
Type 5: Looks like chicken nuggets. I don’t think I’ll be able to look at chicken nuggets quite the same way ever again.
Type 6: Looks like porridge; and…
Type 7: Looks like gravy. You got to love them Brits.

The best #2 is a #4; a smooth and soft snake. Unfortunately, only a minority of adults enjoy normal bowel function, and only about half pass normal stools. Wow. And younger women, due to hormonal fluctuations throughout their cycle, are particularly disadvantaged.

But this is for people eating a standard Western diet. Wouldn’t it be neat if some researchers compared bowel function measurements between individuals eating different diets? It would, and they did.

Bowel function was assessed: omnivores, versus vegetarians, versus vegans. Each subject was provided with a “stool collection kit,” a stack-a-boxes each used to accommodate one stool only, reducing the risk of specimens becoming squashed. They weren’t messing around.

So, meat-eaters versus plant-eaters, put to the test. First question: where did the meat-eaters fall? Does the average bowel movement of meat-eaters look like rabbit droppings, bunches of grapes, corn on the cob, a smooth and soft sausage, chicken nuggets, oatmeal, or gravy?

Meat-eaters, on average, poop out corn cob stools. What about vegetarians? 1, 2, 3, 4, 5, 6, or 7? #4, right where we want to be. And finally, what about vegans, on average? #4 as well.

But, vegans actually ended up beating vegetarians, because none of the vegans had the hard rabbit-turd stools, whereas a few of the vegetarians, like a bunch of the meat-eaters, struggled to pass type 1s. And, the smooth vegan snakes were softer—exactly 18% softer. How could they tell? Using a stool penetrometer, of course.

An editorial in the Canadian Medical Association Journal celebrated the finding this year, calling on doctors to tell all their patients to eat a plant-based diet, as vegetarian diets can only help push patients into the comfortable middle range of the much-beloved Bristol Stool Scale.

Please consider volunteering to help out on the site.

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Last year, the University of Bristol celebrated their 100-year anniversary. Prestigious institution of higher learning. Produced nine Nobel laureates and the Bristol Stool Scale, a medical tool used to classify the fecal form. Seven different classifications: 

Type 1: Looks like rabbit droppings. Separate hard lumps, like nuts; hard to pass.
Type 2: Looks like a bunch of grapes. Sausage-shaped, but lumpy.
Type 3: Looks like corn on the cob.
Type 4: Like a sausage or snake, smooth and soft.
Type 5: Looks like chicken nuggets. I don’t think I’ll be able to look at chicken nuggets quite the same way ever again.
Type 6: Looks like porridge; and…
Type 7: Looks like gravy. You got to love them Brits.

The best #2 is a #4; a smooth and soft snake. Unfortunately, only a minority of adults enjoy normal bowel function, and only about half pass normal stools. Wow. And younger women, due to hormonal fluctuations throughout their cycle, are particularly disadvantaged.

But this is for people eating a standard Western diet. Wouldn’t it be neat if some researchers compared bowel function measurements between individuals eating different diets? It would, and they did.

Bowel function was assessed: omnivores, versus vegetarians, versus vegans. Each subject was provided with a “stool collection kit,” a stack-a-boxes each used to accommodate one stool only, reducing the risk of specimens becoming squashed. They weren’t messing around.

So, meat-eaters versus plant-eaters, put to the test. First question: where did the meat-eaters fall? Does the average bowel movement of meat-eaters look like rabbit droppings, bunches of grapes, corn on the cob, a smooth and soft sausage, chicken nuggets, oatmeal, or gravy?

Meat-eaters, on average, poop out corn cob stools. What about vegetarians? 1, 2, 3, 4, 5, 6, or 7? #4, right where we want to be. And finally, what about vegans, on average? #4 as well.

But, vegans actually ended up beating vegetarians, because none of the vegans had the hard rabbit-turd stools, whereas a few of the vegetarians, like a bunch of the meat-eaters, struggled to pass type 1s. And, the smooth vegan snakes were softer—exactly 18% softer. How could they tell? Using a stool penetrometer, of course.

An editorial in the Canadian Medical Association Journal celebrated the finding this year, calling on doctors to tell all their patients to eat a plant-based diet, as vegetarian diets can only help push patients into the comfortable middle range of the much-beloved Bristol Stool Scale.

Please consider volunteering to help out on the site.

Doctor's Note

For more on stool and health, check out:
Stool pH and Colon Cancer
Bulking Up on Antioxidants
Preventing Ulcerative Colitis with Diet

And check out my other videos on stool

For more context, also see my associated blog posts: Bowel Movements: The Scoop on PoopKiwi Fruit for Irritable Bowel SyndromeNutritionFacts.org: the first monthBoosting Gut Flora Without Probiotics, and Best Treatment for Constipation.

If you haven’t yet, you can subscribe to my videos for free by clicking here.

28 responses to “Bristol Stool Scale

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  1. Nice… by the way, I’m happy to have come across this site. I’m a primary care doctor in Wisconsin and likely will be recommending certain things to patients. Thanks a lot!




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    1. You’re so sweet to take the time to leave a note. Because even the scientific nutrition literature can be such dry technobabble, I’m always trying to find ways to insert some humor or something just so the material’s not so dense. Sometimes I’m more successful than others, but I have been looking forward to posting the one this morning. Whole new meaning to the term “brain food”! :)




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  2. I think I’m glad looking at this Bristol Scale. My stools have changed a bit. And according to this scale, I’m a “Type 4”. I don’t eat meat. Maybe once in a while I have fish. I was still sometimes a Type 3, but the past month I’ve only been a 4. So I hope that doesn’t mean anything bad. I don’t feel blocked up, or blotted, So the thinner type 4 is where I’m at now. I’ve been a vegetarian for several years and am pre-menopausal.




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  3. I have created an iPhone application which brings the Bristol Stool Scale to your iPhone. It’s easy to use, and easy to understand. Over time it creates a graph of your stool quality which you can share with your health professional. This could help in monitoring the effects of lifestyle or drug changes, medical treatments, etc, over time. The app also includes links to some online resources and a brief explanation of each type of stool.

    If you’d like to know more have a look at the website here: http://www.bristol-stool-scale.com/

    Thanks,

    David




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  4. Dr. G, thanks for teaching us about the Bristol scale. My life has been profoundly changed by this knowledge, not least because it helped me realize it isn’t neurotic (after a lifetime of reading and hearing doctors opine that it is neurotic for patients to dwell or even spend any time on the topic) to regularly observe my doo and use it as a clue (one of many) to how I’m doing overall!

    Might there be an analogous scale for the other end of the tract, namely, tongue coatings?




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    1. Not sure about tongue coating scales, but that would be interesting. I know acupuncturists and Chinese medicine evaluates the tongue.




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  5. What would it mean if a vegan like myself were to vacillate between numbers 1 and 5? I have wondered for a long time because I think of the animals in the wild who are herbivores. Don’t they all have pellet stools for the most part?




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  6. I used to have the smooth sausage and occasionally #3 before switching to plant-based in 2012 and now it’s like a cow patty that sticks when flushed and leaves more skid marks than race cars at the Indy 500. I find this really annoying when I’m sharing a bathroom with someone or at a friend’s house, etc. I’m wondering it I’m getting too much fiber as I consistently come in around 100 or more grams a day based on about 3500 calories, which is because I’m very active and have an appetite to match. I tried drinking more water, but that just made it worse….I’d really like to get back to #4 but not sure what to “doo”?




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    1. I know this is an old post but I’m still hoping for an answer. I have the same issue. Worse, I get cramps, bloating, diarrhea and even steatorrhea at times. This is only when I add more veggies to my diet. I love veggies but my body doesn’t seem to digest them very well. Any clue?




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      1. Hi Isa-
        I’m starting to think we won’t get a response since this is an older post….question: did you ever eat animal products, and if so, were your movements better during that time?




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