The Bristol scale scales are diagnostic medical devices designed to classify human faeces into seven categories. It is used in clinical and experimental fields. Sometimes it is also referred to as the Bristol stool chart ( BSC ), Bristol stool form , or BSF scale .
It was developed at Bristol Royal Infirmary as a clinical assessment tool in 1997, and is widely used as a research tool to evaluate the effectiveness of treatments for various bowel diseases, as well as clinical communication aid; including being part of a diagnostic triad for irritable bowel syndrome.
Video Bristol stool scale
Interpretation of scale
The seven types of benches are:
- Type 1: Separate the hard lumps, such as nuts (difficult to pass); also known as goat droppings
- Type 2: Sausage, but thick
- Type 3: Like a sausage but with a crack on its surface
- Type 4: Like a sausage or a snake, smooth and soft
- Type 5: Soft blobs with clear tips (easy to skip)
- Type 6: Fine pieces with rough edges, soft stools
- Type 7: Watering, no solid pieces, all liquid
Types 1 and 2 show constipation, with 3 and 4 being ideal stools because it is easy to defecate while not containing excess fluid, 5 tends to lead to diarrhea, and 6 and 7 show diarrhea.
In preliminary studies, in populations examined on this scale, type 1 and 2 faeces were more common in women, whereas type 5 and stool 6 were more common in men; Furthermore, 80% of subjects who reported rectal tenesmus (urgency to defecate) had type 7. These and other data have enabled the scale to be validated.
Bristol's stool scale is also very sensitive to changes in transit time in the intestine caused by drugs, such as loperamid antidiarrhoeal or senna, anthraquinone substances with laxative effects.
Maps Bristol stool scale
History
Developed and proposed for the first time in the UK by Dr. Stephen Lewis and Dr. Ken Heaton at the Department of Medicine University, Bristol Royal Infirmary, was advised by the authors as a clinical assessment tool in 1997 in Scandinavian journals. Journal of Gastroenterology after a previous prospective study, conducted in 1992 on population samples (838 men and 1,059 women), has demonstrated the prevalence of unexpected bowel disorders associated with the shape and type of stool. The authors of the previous paper concluded that the stool form is a useful replacement measure of intestinal transit time. The conclusion has since been challenged to have limited validity for Type 1 and 2; However, it remains to be used as a research tool to evaluate the effectiveness of treatments for various bowel diseases, as well as clinical communication aid.
Version
The same scale has been validated in Spanish, Brazilian Portuguese, and Polish versions. Version A has also been designed and validated for pediatrics. More recently, in September 2011, the modified version of the scale was validated using self-assessment criteria for ages 6-8 years.
Usage
Diagnosis of IBS
Patients with IBS or irritable bowel syndrome usually report that they have stomach cramps and constipation. In some patients, chronic constipation is interspersed with short episodes of diarrhea; while a small proportion of patients with IBS experienced only diarrhea. Presentation of symptoms is usually months or years and usually patients consult different doctors, without great success, and perform special investigations. It notices strong correlation of symptoms reported with stress; indeed diarrhea discharges are associated with emotional phenomena. IBS blood is present only if the disease is associated with haemorrhoids.
Research conducted on irritable bowel syndrome in 2000, faecal incontinence and HIV gastrointestinal complications have used the Bristol scale as an easy-to-use diagnostic tool; even in studies that lasted for 77 months.
Historically, the faeces assessment scale has been recommended by the consensus group Kaiser Permanente Medical Program (San Diego, California) for data collection on functional bowel disease (FBD).
More recently, according to the latest revision of the Rome III Criteria, six clinical manifestations of IBS can be identified:
These four identified subtypes are correlated with stool consistency, which can be determined by Bristol's stool scale.
In 2007, the Mayo Clinic College of Medicine in Rochester (USA) reported part of an epidemiological study conducted on a population of 4,196 people living in Olmsted County (Minnesota), where participants were required to complete questionnaire based on Bristol stool scale .
The results (see table) show that about 1 in 5 people have slow transits (type 1 and 2 stools), while 1 in 12 have an accelerated transit (stools 5 and 6). In addition, the nature of feces is affected by age, sex, body mass index, whether they have cholecystectomy and possible psychosomatic components (somatization); there is no effect of factors such as smoking, alcohol, education level, history of appendicitis or familiarity with gastrointestinal diseases, civilian state, or use of oral contraceptives.
Therapeutic Evaluation
Some studies correlate Bristol's stool scale in response to medication or therapy; in fact, in one study it was also used to titrate the dose more subtly than a single drug (colestyramine) on the subject with diarrhea and faecal incontinence.
In a randomized controlled study, this scale was used to study responses to two laxatives: Macrogol (polyethylene glycol) and psyllium ( Plantago psyllium and other species of the same genus) of 126 male and female patients for a period 2 weeks treatment time; failed to show the most rapid response and improved efficiency from the previous one. In the study, they were measured as primary outcome: number of weekly bowel movement, consistency of stool according to type Bristol stool scale , time to defecate, overall effectiveness. , difficulty in bowel movements and fecal consistency.
Source of the article : Wikipedia
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