Decoding Your Bowel Movements

It wasn’t until I started seeing a gastroenterologist (GI) that I began having some of the most uncomfortable conversations of my life. After all, one of the most common conversations with GIs includes the question, “How’s your poop?” I always tried to get through this conversation as quickly as possible because, honestly, I was never sure how to describe my poop. I wish I had known at that time that there is something called the Bristol Stool Scale (or the Meyers Scale if you’re in the UK) that is designed to help us get through those tough discussions.

The Bristol Stool Scale describes seven different types of stool, and with the results from the scale, a GI is often much closer to helping you:

Credit: National Health Service, St. Helens and Knowsley Teaching Hospital

Type 1: Separate hard lumps, like nuts (hard to pass)

Type 1 stools are a real pain in the butt. They’re difficult to pass and often cause discomfort. This stool has spent the longest amount of time in your bowel, and you’re probably more than ready to give it an eviction notice. But be careful because these stools can often be hard or abrasive to your intestines and rectum and may cause some anorectal bleeding.

Type 2: Sausage-shaped but lumpy

Fair warning: Type 2 stools are probably the worst on this list when it comes to discomfort. Essentially a Type 2 stool is like a Type 1 stool but firmer, which means harder to pass. In fact, because they are more formed, they are often close to or the same size as the average anus, causing some serious problems on the way out.

Be careful about extreme straining, fissures on the anus, hemorrhoidal prolapses, and even diverticulosis. These stools have probably been hanging out in your colon for a few weeks, which is significantly longer than the average 48-72 hours. If you’re experiencing this type of stool, be careful with your fiber intake. Chances are your bowels are pretty full and by adding fiber, you’re giving your stool nowhere to go. In the end that will just cause more pressure and discomfort.

Type 3: Like a sausage but with cracks on its surface

Type 3 is a bit closer to what a “normal” stool looks like. It may have similar qualities of a Type 2 stool but it is smaller and will be in your intestines for much less time, therefore making it a lot easier to pass.

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

Chances are this is the type of stool you have when you’re having a great day. It takes little effort to pass these stools, they cause little discomfort, and you feel good after you’re done. If this sounds like you, you’re probably pooping about once a day, which is great.

Type 5: Soft blobs with clear cut edges (passed easily)If you’re in the bathroom two to three times a day, it is likely that you’re a Type 5 pooper. These stools are a lot softer than Types 1-4, and have a quicker transit time. There should be no pain or discomfort with a Type 5 stool.

Type 6: Fluffy pieces with ragged edges, a mushy stool

The Type 6 stool can be the beginning of some discomfort for you if you’re not careful. You probably will have some increased urgency with this type of stool and because it tends to be a bit messier, i.e., you might need the help of some wet wipes or a bidet. You can try to add some fiber to your diet to see if that helps create a more formed stool. If you’re experiencing Type 6 stools, you may want to look at your lifestyle and ask yourself a few questions. Are you stressed out? Do you eat a lot of fatty foods? What about spicy foods? If Type 6 is your regular bowel movement, it might be a sign that you need to change a few things.

Type 7: Watery, no solid pieces, entirely liquid

I hope you’re drinking a lot of water if you’re experiencing Type 7 stools. This is diarrhea as we know it. You may have some urgency, some discomfort and pain, and more than likely are passing mostly liquid, which means you’re at risk for dehydration. Dehydration can be a very serious medical condition, so take it seriously!

Important takeaways:* ** Type 1 and 2** probably means you’ve got constipation. Lay off the fiber and be nice to your digestive system

• Type 3 and 4 are close to what is considered “normal” for most people

• Type 5 can also be a “normal” for many people depending on one’s usual frequency

• Type 6 and 7 indicate diarrhea and you may need to increase your fiber intake and definitely increase your water consumption** If your doctor asks you to explain what your poop looks like, use this chart to make things feel less awkward and also to give your doctor some real information that isn’t hidden behind embarrassment.**

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Jackie is an ulcerative colitis patient and the founder and Executive Director of Girls With Guts. Since diagnosis, she has been blogging her IBD journey at Blood, Poop, and Tears. Jackie has worked hard to become a strong voice in the patient advocacy community, and pays it forward as Social Ambassador of the IBDHealthCentral Facebook page.