The Paediatric Aussie Chocolate Poo Scale

The Bristol Stool Scale (BSS) was developed 30 years ago, with the aim of determining the range of bowel habits including stool types in the adult population.1 We conducted a PubMed search (All Fields), which identified more than 600 published papers associated with the BSS. The BSS is currently the gold standard to classify stool consistency in adults. In its present form, it has been useful in assessing intestinal transit time;2 the longer the time, the lower the stool number (eg, type 1 has the slowest transit time [constipation]; type 7 has the fastest transit time [diarrhoea]) (Box 1). The form of the stool strongly influences the act of defecation. The need to strain increases as the type number goes down, and the feeling of urgency increases as the type number rises.1 Feelings of incomplete evacuation occur quite often in normal individuals if their stool is at either end of the scale, but rarely if the stool is type 3 or 4.