Bristol Stool Chart PDF [Free Download]

Are you looking for a free Bristol Stool Chart PDF? You can download a free copy through the Rome Foundation’s Bristol Stool Form Scale.

In this article we will discuss the levels of the Bristol Stool Chart, what is normal, and how to improve your bowel health.

What is the Bristol Stool Chart?

The Bristol Stool Chart is formally known as the Bristol Stool Form Scale (BSFS). This tool helps people to determine their type of bowel movements (Ref). The scale breaks down bowel movements into 7 distinct types. We’ll dig into the types and what they mean soon.

Why Stool Type Matters

Why does your type of stool matter? It can help you to identify what is normal and if you are experiencing constipation or diarrhea. It can also help you to articulate to your health care team what you are experiencing when you are using the restroom.

Sometimes bathroom talk can make people uncomfortable. Everyone poops. And it absolutely should not be an area of shame or embarrassment. But unfortunately, embarrassment happens and it can be a barrier in getting good medical treatment for the bowel issues you are experiencing.

If you are not able to clearly articulate what you are experiencing in the bathroom, including your stool type, your health care team might not be able to provide the best interventions for you.

Why Stool Type Matters

Embarrassed to Talk About Poop?

When I was in middle school I became lactose intolerant.  However, I was embarrassed by the symptom of diarrhea. So I didn’t tell my doctor about it. I just said I was having stomach aches. And, of course, without the whole picture how could my doctor help me?

It wasn’t until I was in my first nutrition class in community college that I figured out that I was lactose intolerant.  I suffered for year and years when I didn’t have to.

If you struggle with embarrassment over this discussion, I want to both encourage and empower you. It’s OK to speak up. To healthcare professionals, we talk about poop all the time. It’s not a big deal. And we really are here to help and support you!

Knowledge of the Bristol Stool Chart (aka Bristol Stool Form Scale) can help you to bring up and have uncomfortable conversations. Print out the free Bristol Stool Form Scale Card and bring it in to your next doctor appointment. Use it as a starting point to talk about any issues you may be having.

But most importantly, have the conversation. If you are struggling with constipation or diarrhea (or both!), you don’t have to be. If you are suffering in silence, I hope you feel encouraged to make the call to your doctor. You can do this.

Bristol Stool Chart PDF Download

Download the Bristol Stool Chart PDF (aka Bristol Stool Form Scale Card) here.

Bristol Stool Chart PDF download

Bristol Stool Chart Levels

Here’s the Bristol Stool Form Scale breakdown! Types 1-2 indicate constipation. Types 3-5 are ideal. And types 6-7 indicate diarrhea.

  • Type 1: Separate, hard lumps, like nuts (hard to pass)
  • Type 2: Sausage shaped, but lumpy
  • Type 3: Like a sausage but with cracks on its sausage
  • Type 4: Like a sausage or snake, smooth and soft
  • Type 5: Soft blobs with clear cut edges (passed easily)
  • Type 6: Fluffy pieces with ragged edges, a mushy stool
  • Type 7: Watery, no solid pieces. Entirely liquid

Regular Bowel Movements

So, what is normal? When it comes to your bowel movements everyone seems to have their own normal. We are all unique. But, in general your bowel movements should pass easily and be well formed. You should be using the restroom on a regular basis. And using the restroom should not be a struggle.

Types 3-5

On the Bristol Stool Chart, types 3-5 are considered normal. You’ll notice this is a pretty wide range of stool types. Anywhere from a cracked sausage shape to soft blobs.

When it comes to figuring out what is “normal”, you can see that there is a wide variety. Remember, the key is that the stool is easily passed and well formed. Your normal may be different from someone else’s normal.

Maintaining Good Bowel Health

Good Bowel HealthMaintaining good bowel health typically includes three steps:

  • Eating plenty of fiber
  • Drinking enough fluid
  • Being physically active

Fiber provides bulk to help stool pass. Fluids help keep things lubricated and moving. And physical activity helps to keep the body and bowels healthy.

Having regular appointments with your healthcare team is also very important. Medical conditions, medications, and even supplements can have an impact on bowel health. It is important to treat any underlying issues if you begin to have issues with your bowels.

What is Constipation?

Constipation is difficulty having bowel movements and/or having less frequent bowel movements. Anyone can experience constipation, but it is more common in the elderly and women.

Constipation can be caused by many different issues from lifestyle (not getting enough fiber, fluid, or exercise), medications (including supplements), and medical conditions (colon issues, neurological disorders, and metabolic issues).

Types 1-2

On the Bristol Stool Chart, types 1 and 2 indicate constipation. This can include separate, hard lumps that look like nuts or marbles. It can also include a sausage shape cluster of these lumps.

These stools may be harder to pass and require more straining.

Preventing & Treating Constipation

Constipation on the Bristol Stool ChartThe first line of defense in treating (and preventing!) constipation are lifestyle factors.

This includes eating more fiber, drinking more fluid, and being physically active.

This may also include evaluating medications and supplements being used as some may contribute to constipation. Always discuss your issues with constipation with your healthcare team.

Food high in fiber include whole grains, fruits, vegetables, nuts, beans, legumes, and seeds. You can also read the nutrition facts label on pre-packaged foods to determine the fiber level.

Just eating more fiber isn’t enough. You need to drink more fluids as well to balance the extra fiber you are eating. Introduce fiber slowly and opt for whole food fiber sources.

Some individuals may require medications to help manage their constipation. Particularly those with medical conditions or those on other medications that are contributing to the constipation. Talk to your doctor about the best options for you.

You can learn more at our article Treating Constipation in the Elderly.

What is Diarrhea?

While constipation is defined as less frequent and more hard stools, diarrhea is the opposite. Diarrhea includes more frequent bowel movements and/or more watery stools.

Some people experience diarrhea short term. It only occurs once in a while. Others experience chronic diarrhea where, unfortunately, diarrhea has become their norm. Chronic diarrhea (lasting several weeks) comes with increased health concerns and issues.

Diarrhea can be caused by many different factors from food born illness, to viruses or infections, to chronic disease (irritable bowel syndrome and inflammatory bowel diseases), or even as a side effect from medications or supplements.

Because of the increased frequency and water loss, those with diarrhea are at risk for dehydration and electrolyte imbalances. And because things are moving through the GI tract quicker, this can cause issues with nutrient absorption.

Diarrhea also can affect quality of life. It’s uncomfortable, at times painful, and just plain inconvenient.  Older adults are also at a greater risk for health issues due to chronic diarrhea.

Types 6-7

On the Bristol Stool Chart, types 6 and 7 indicate diarrhea. This can include mushy stool with pieces that have ragged edges. It can also include a watery stool that is completely liquid.

These stools are very watery and generally do not have solid/formed pieces of stool.

Preventing & Treating Diarrhea

Diarrhea on Bristol Stool ChartTreatment of diarrhea ultimately depends on the cause.

Work with your healthcare team to determine the best interventions for your individual situation.

If there is an underlying issue causing the diarrhea, the ultimate goal is to treat that underlying issue.  For example, if the diarrhea is being caused by a virus or infection, the goal is to treat the virus or infection.

Other goals include to (Ref):

  • Treat dehydration and electrolyte imbalances.
  • Improve the consistency of the stool.
  • Slow the rate of foods going through the GI tract.

Dehydration and Electrolyte Imbalances

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Diarrhea, especially chronic diarrhea, can make you dehydrated. Simply drinking more water might not resolve the issues occurring from the diarrhea. Along with the water loss, there is an imbalance of electrolytes that needs to be restored.

To restore both fluid and electrolyte imbalances, drinking “rehydrating solutions” are beneficial. This is why you see extreme athletes drink beverages like Gatorade* or Powerade*. These products contain electrolytes (ex. sodium, chloride) to make up for the fluids they are losing from sweating.

Products like Pedialyte* and Rehydrate* can be used for issues with dehydration.


Consistency of the Stool

Consistency of the stool can be improved through adding foods containing pectin. Examples include banana flakes* or apple powder*. You can learn more at our article on Banana Flakes.


Slowing Down the GI Tract

One main way to get foods to slow down as they pass through the GI tract is to identify and avoid trigger foods that cause diarrhea. Different people have different trigger foods.

Common trigger foods include (Ref):

  • Simple carbohydrates
  • Sugar alcohols (ex. sorbitol)
  • Coffee or soda (caffeine)
  • Alcohol
  • Gas-producing foods (ex. beans, cruciferous veggies)

Other Interventions

Other interventions for treating diarrhea may include taking probiotics or prebiotics. This can be through eating more food sources and/or taking supplements as needed.

Conclusion: Bristol Stool Chart PDF

Hopefully this has been helpful in understanding how you can use the Bristol Stool Chart to assess your bowel movements. Getting to normal may include lifestyle or medical interventions, depending on your situation.

Being able to describe your stool types on the Bristol Stool Chart will help your healthcare team best understand what you are experiencing. Also be sure to share the frequency in which you are having bowel movements.

Best of luck and don’t forget to snag a copy of the Bristol Stool Chart PDF here.

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