Stools tell if you're healthy - here's how to interpret the Bristol Scale for a patient

By Cristiano Antonino On Apr 19, 2023

Let’s talk about the Bristol Scale: the waste produced indicates a lot about the health of a living organism

For example, feces change colour, smell, structure and consistency based on the type of diet and the correct/incorrect functioning of your intestine, so it would be good practice, after evacuation, to check that the feces are within a normal range .

Bristol scale and patient’s state of health: what are “healthy” stools like?

The ideal feces:

they are dark gold/light brown/dark brown;
have the shape of an elongated cylinder;
they have a homogeneous or slightly cracked structure;
they have a solid but not excessively hard consistency;
they float or sink;
they are not “painted” in bright red blood;
do not include traces of dark blood or pus;
they have the characteristic fecal odor;
they do not include undigested elements, even if it is possible to physiologically find some types of food in the faeces, such as corn and some legumes for example: this should not worry.

The 5 signs to look out for:

1) frequency of evacuation;

2) smell of feces;

3) stool flotation;

4) shape and consistency of feces;

5) stool color.

1) Frequency of evacuation

Defecation should take place once a day, usually in the morning, after having taken hot coffee, which can stimulate the gastrocolic reflex (a nervous impulse physiologically transmitted from the stomach to the colon when the gastric walls are stretched by food and which determines an increase in intestinal motility).

Regularity of defecation is a basic condition for good health: an irregularity in the evacuation of feces could be a symptom of intestinal problems, pathologies or even a particular emotional stress.

Some people manage to go to the bathroom even 2 or 3 times a day.

There are many factors that can influence the frequency of bowel movements, including:

subjective metabolism;
subject’s age;
general state of health of the subject;
hormones (an increase in thyroid hormones can increase the frequency of bowel movements);
paralytic ileus (state of intestinal obstruction in the absence of an obvious cause of obstruction);
mechanical ileus (intestinal obstruction caused by many causes such as fecal impaction, adhesions, foreign bodies, strangulation by volvulus, clusters of helminths, compression by masses of various kinds…);
amount of bacteria contained in the intestine;
quantity and quality of ingested food;
fiber intake;
emotional state of the subject.

2) Smell of feces

A bad smell of feces can be a symptom of bad digestion or inadequate nutrition, but also of malabsorption.

3) Stool flotation

Particularly “heavy” faeces that sink into the water could be a symptom of bad digestion or inadequate nutrition, but also of ineffective chewing.

Stools that are particularly light and floating on water could indicate fat malabsorption.

4) Shape of the stool, the Bristol Stool Scale

To interpret the correct shape and consistency of the stools, a practical reference called Bristol Stool Scale or Bristol stool scale can help us, which you can see in the image below:

Type 1: Hard lumps separated from each other, such as walnuts / hazelnuts (difficult to expel); also called goat feces: they are an expression of severe constipation.

Type 2: In the shape of a sausage, but formed by lumps joined together: they indicate constipation of lesser extent than the previous type.

Type 3: Like a salami, but with cracks on its surface: this is normal feces.

Type 4: Like a sausage or a snake, smooth and soft: this is normal stool.

Type 5: Soft separate pieces with edges like cut/broken; clear (easy to evacuate): these are normal stools even if in some cases they could indicate a lack of fiber in the diet.

Type 6: Soft/floccular pieces with jagged edges, pasty stools: may be a sign of inflammation.

Type 7: Watery, no solids, diarrhoea, loose stools: indicate malabsorption and inflammation.

5) Color

The perfect color should be between light brown and dark brown and should be homogeneous.

Whole food pieces should not be present in healthy stools, although in some cases it is possible to find undigested or incompletely digested food even in the absence of disease (e.g. corn).

Newborn feces

The baby’s feces should be yellow-orange and rather soft and quite foul-smelling.

But in general, there is no need to be alarmed by every apparently anomalous sign, given that the digestive tract of a newborn (like the rest of his body) is in continuous dynamic transformation.

If the pediatrician is calm, the parents must also remain calm.

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