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Usefulness of Assessment of Stool Form by the Modified Bristol Stool Form Scale in Primary Care Pediatrics

Reema Gulati1, Arpitha Komuravelly1, Stephen Leb2

  • 1Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, OH, USA.

Pediatric Gastroenterology, Hepatology & Nutrition
|May 2, 2018
PubMed

Insights

The modified Bristol stool form scale (m-BSFS) can help diagnose constipation in children. However, its assessment of hard stools showed poor agreement with the Rome criteria, suggesting a need for clearer visual aids in pediatric bowel habit assessments.

Area of Science:

  • Pediatric Gastroenterology
  • Clinical Diagnostics
  • Bowel Habit Assessment

Background:

  • Rome criteria are the standard for diagnosing functional constipation.
  • The modified Bristol stool form scale (m-BSFS) is validated for assessing stool form in children.
  • Limited research exists on m-BSFS for constipation diagnosis facilitation and its agreement with Rome criteria.

Purpose of the Study:

  • To evaluate the modified Bristol stool form scale (m-BSFS) as a tool to facilitate constipation detection in children.
  • To assess the agreement between stool form measured by m-BSFS and the hard stool criteria defined by the Rome criteria.

Main Methods:

  • A survey combined Rome III criteria and the m-BSFS.
  • A Likert scale was used to record the frequency of each stool form on the m-BSFS.
  • Responses from Rome III and m-BSFS were compared.

Main Results:

  • The m-BSFS demonstrated a sensitivity of 79.2% and specificity of 66.0% for detecting constipation.
  • In children under 4 years, sensitivity improved to 81.2% and specificity to 75.0%.
  • Poor agreement was observed between m-BSFS hard stools and the Rome Criteria's painful or hard bowel movement assessment.

Conclusions:

  • The m-BSFS shows potential as a tool to aid in diagnosing constipation in children.
  • Discrepancies in assessing hard stools highlight potential differences in perception between questionnaire-based criteria and pictorial scales.
  • A visual tool like m-BSFS could complement inquiries about bowel habits in pediatric care.
Abstract

Keywords:
ConstipationModified Bristol formRome criteriaStool consistency

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