Bristol Stool Chart: What It Can Tell You About Your Health

The Bristol Stool Chart can tell what your poop’s shape might mean, but you’ll want to dig deeper to understand why color plays a significant role too.

bristol stool chart

Changes in your stool shape or texture can indicate an illness: a C-diff infection, thyroid problems, inflammatory bowel disease, cancer, a parasitic infection, or worse.

© Tomnex |

Do you use the Bristol Stool Chart?’ The Bristol Stool Chart is a human-poop evaluation guide developed at the British Royal Infirmary in 1997. It can help you determine if your feces are normal. The Bristol Stool Chart—also called the Bristol Stool Scale—s widely used in clinical settings, especially with patients battling irritable bowel syndrome.

Poop—or, more politely, “stool”—is a reflection of our digestive processes, our activity levels, and our overall health. The Bristol Stool Chart, which is largely based upon the consistency and shape of feces, is a way to classify what we see in the bowl before we flush it away. The seven types of stool are as follows:


1 Separate hard lumps, like nuts
2 Sausage-shaped but lumpy
3 Like a sausage but with cracks on the surface
4 Like a sausage or snake, smooth and soft
5 Soft blobs with clear-cut edges
6 Fluffy pieces with ragged edges, a mushy stool
7 Watery, no solid pieces, entirely liquid


Deciphering the Bristol Stool Chart

Types 1 and 2 on the Bristol Stool Chart reflect levels of constipation. When you’re constipated, your feces stay in your body for longer than normal. When it stays in the intestine, the stool drys out and normal, healthy bacterial are destroyed. Constipated poop, says, has remained in your intestines for weeks instead of the normal 72 hours. Old poop becomes hard.

Passing Type 1 or 2 stool can be associated with some rectal bleeding, due to how hard and difficult to move the stool is. The causes for this level of constipation vary, but they can be associated with a low-fiber diet and/or sedentary lifestyle. “Adding supplemental fiber to expel these stools is dangerous, because the expanded fiber has no place to go, and may cause hernia, obstruction, or perforation of the small and large intestine alike,” says

Constipation also may be associated with an unwillingness to defecate, pain, and/or hemorrhoids.

Depending upon what expert you consult, Types 3, 4, and 5 are normal. Type 3 may be slightly on the constipated side, Type 5 a bit loose. But either could be normal for you, based on your diet and physical activity. The differences drive home the point that we need to know our own “normal.”

Types 6 and 7 are levels of diarrhea from mushy to watery. At Type 6, the loose stool could be due to stress (including physical activity) or a dietary change. The poop hasn’t stayed long enough in the intestines for the body to extract all the water and nutrients, so it’s “squishier.”

When you’re at Type 7, you have stool that pours out of you like water. You can dehydrate quickly at this level, because the intestines aren’t absorbing any water from the feces.

Certain symptoms should prompt you to see a doctor:

  • Diarrhea lasting for more than two days
  • A fever of 102°F or higher
  • Six or more loose stool bowel movements within a 24-hour period
  • Vomiting
  • Severe pain in your abdomen area
  • Unusual pain in your rectum
  • Blood in your stool
  • Stools that are black and tarry or that contain pus
  • Dehydration (increased thirst, dry mouth, weakness, dizziness, palpitations, confusion, sluggishness, fainting)

Change Is Not Always Good

Changes in your stool shape or texture can indicate an illness: a C-diff infection, thyroid problems, inflammatory bowel disease, cancer, a parasitic infection, or worse. It can also reflect your diet, stress, food intolerance, or activity level, but the important thing is not to assume any change is normal until you discuss it with your doctor. This is especially true for any change that lasts more than two weeks. While diarrhea should be seen by doctor if it lasts for 48 hours, other changes are usually OK to give two weeks to resolve, especially if there are no related symptoms (more on color below).

It’s interesting to note that some physicians become concerned if you tell them you’re seeing “flat” and/or narrow stools instead of rounded feces because the doctors surmise that the flat shape could indicate a blockage or tumor of some sort. This isn’t always the case, but it is important to find out for certain

The Color of Poop

Emphasizing the shape of your waste without considering color is a like reading an abridged novel. You’re getting the gist of the story but not the whole tale.

Normal poop, as most of us know, is a shade of brown. The color comes from the intestines metabolizing the bile from your gallbladder. The liver produces the bile, which is stored in the gallbladder and released to aid in digestion. While you can have various shades of brown, possibly even greenish-brown, other stool colors may indicate disease.

Before you become concerned, you may experience normal temporary changes in stool colors can be due to what we consume, as you’ll see below, but any color change that cannot be explained by something you consumed and does not quickly resolve should be discussed with your doctor. Note: This is one of the many reasons you’re wise to read the information that comes with any prescription drug you’re taking, checking for side effects.

Black: While you might be able to wait a week or two for some fecal changes to normalize, don’t mess around if you see black stool, especially if it reminds you of coffee grounds. This may indicate bleeding, and blood loss can be an emergency. That said, iron supplements and medications that contain bismuth subsalicylate like Pepto-Bismol can temporarily turn your stool black, but the color should normalize in 24 hours.

Red: A bright red blotch or color on your stool likely indicates gastrointestinal bleeding, probably from the rectum, hemorrhoids, or the large intestine. Eating red foods, like beets or tomatoes, may cause temporary reddish stool.

Pale (white, gray, yellowish): Pale stools can indicate liver, pancreas (pancreatic cancer), or gallbladder problems. Poor fat digestion is another cause, although some medications like antacids with aluminum hydroxide can cause pale stool.

Green: Green may indicate a problem with the digestive system, such as not secreting enough bile. Crohn’s disease and celiac disease can both cause green poop.

Orange: While this color is usually caused by dietary overeating of orange veggies like winter squash and carrots, it could indicate a blocked bile duct.


Since poop results from the digestive process, it stands to reason that it will smell. Most of us find the scent unpleasant and politely open a window or spray an air freshener when we leave the bathroom. However, if the smell is abnormally offensive, you may want to consider why (and still use that air spray!).

Particularly smelly feces may mean a digestive issue like malabsorption, which may be due to an illness like Crohn’s disease, lactose intolerance, or a food allergy.

However, it could also indicate that you have parasites or another type of infection that needs to be addressed such as gastroenteritis, a bacterial infection, or a virus. If foul-smelling poop is associated with unusual color, shape, or consistency symptoms, or if you’re experiencing flatulence or bloating, consult your physician.

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Cindy Foley

Cindy Foley is the editor of several health reports, including Managing Your Cholesterol, Core Fitness, and Brain Power & Nutrition, among others. Foley has worked in the private medical practice field … Read More

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