The shape of your stools and the frequency in which you go to the toilet reflects your intestinal health and can be used as a way to diagnose problems such as Irritable Bowel Syndrome, poor diet and anal incontinence, as well as being useful in following the recovery of intestinal surgeries.
In normal situations, your stools should have a soft consistency and be able to maintain their shape. It may be slightly elongated, being similar to a sausage, for example. Ideally, the consistency and shape of the stools should not cause pain or difficulty in evacuating. However, small variations are relatively frequent and can happen without indicating a problem, since it can vary according to the food ingested.
The Bristol Stool Scale was created to help assist in the evaluation of stools shape and consistency and shows 7 possible stool formats by means of images and descriptions. The Scale indicates which stool shapes are normal and what are the possible causes associated with each one.
Type 1: small hard pellets
Type 1 feces are characterized by small, hard pellets separated like little balls, usually hard to get out. In general, this format is linked to an acute change in the intestinal flora, such as shortly after the use of antibiotics or a diet without fibers.
Since there is a lack of bacteria and fibers in the intestine, there is nothing to help retain water, making the stools hard and difficult to pass and sometimes bleeding can occur in the anus. In this case it is not common to have flatulence, because there are no bacteria or fibers to provoke fermentation in the intestine and consequently gas production.
To correct this problem, you should increase fiber intake through whole foods, fruits and vegetables, and consume 1 natural yogurt a day, because it is rich in bacteria that is good for the intestine. In addition, your doctor may prescribe probiotics in the form of tablets or powder. See more about what are probiotics and what are they used for.
Type 2: Lumpy sausage
Type 2 is represented by compacted feces into a single mass, but with a lumpy appearance. This is the most painful type because it is stiff and its size may exceed the opening of the anal canal. During evacuation, great effort is needed to eliminate feces and bleeding, fissures, hemorrhoids or diverticulosis are common.
The most common causes of this type of stool are hemorrhoids, anal fissures, retention or defecation delay and a history of chronic constipation, and such cases can lead to irritable bowel syndrome due to the continuous pressure of large feces in the intestinal walls. To treat, you need to go to the doctor and do tests, but probiotics and medicines that stimulate intestinal transit are also used as well as a balanced diet.
Type 3: Sausage with cracks
This type is very similar to the second type, but the time in which the stool stays in the intestine is smaller, which makes the stool size smaller and evacuation frequency more regular, but it still requires some effort to defecate.
The causes and consequences are the same as type 2, especially the presence of irritable bowel syndrome and the onset of hemorrhoids.
Type 4: Smooth and soft sausage
The feces of type 4 are elongated, smooth and soft, resembling the shape of a sausage or a snake. It is a normal format for those who defecate once a day. In general, they have a diameter of 1 to 2 cm, and evacuation occurs effortlessly.
Type 5: Soft pieces
Type 5 is characterized by feces separated into soft pieces and with well-defined edges, being easy to defecate. It is typical of those who evacuate 2 to 3 times a day, which usually happens after large meals.
Type 6: Pasty and fluffy
This type of stool is a pasty and fluffy mass with irregular borders. In this case it is usually difficult to control the urge to evacuate, and is very messy if you choose to use toilet paper instead of a bathroom shower.
Type 6 may be linked to causes such as mildly hyperactive colon, excessive potassium in your diet, sudden dehydration, or increased blood pressure related to stress. In addition, it may be linked to frequent use of homemade spices, excessive use of energy drinks or laxatives.
Type 7: diarrhea
Type 7 is characterized by diarrhea, which implies that the stools are completely liquid, not containing solid pieces, which are usually accompanied by dehydration and abdominal pain.
It can be caused by several types of diseases, such as viruses, intestinal infection and lactose intolerance, and it is also very common in children who do not have a well-formed intestinal flora yet and in the elderly. See the 6 causes for intestinal pain.
In general, stools in formats 3, 4 and 5 are considered normal, especially when the bowel maintains a good evacuation frequency. See what the color of your stools says about your state of health.