Reliability and Validity of a Modified Bristol Stool Form Scale for Children

Abstract

Objectives This study sought to: 1) evaluate the ability of children to reliably use a modified Bristol Stool Form Scale for Children (mBSFS-C), 2) evaluate criterion-related validity of the mBSFS-C, and 3) identify the lower age limit for mBSFS-C use. Study design The mBSFS-C comprises five stool form types described and depicted in drawings. Children 3–18 years rated stool form for ten stool photographs. Due to low reliability when stool form descriptors were not read aloud (n=119), a subsequent sample (n=191) rated photographs with descriptors read. Results Intraclass correlation coefficients for descriptor-unread versus -read samples were 0.62 and 0.79. Children were increasingly reliable with age. Percentage of correct ratings varied by stool form type but generally increased with age. With descriptors unread, children 8 years and older demonstrated acceptable inter-observer reliability with over 78% of ratings correct. With descriptors read, children 6 years and older demonstrated acceptable reliability and over 80% of ratings correct. Conclusions The mBSFS-C is reliable and valid for use by children, age 6 being the lower limit for scale use with descriptors read and age 8 without descriptors read. We anticipate that the mBSFS-C can be effectively used in pediatric clinical and research settings.

Bowel Preparation for Colonoscopy in Children: 1 Day PEG-3350 with Bisacodyl versus 3 Day Sennosides

“…Patient Questionnaires and Safety Before the initiation of bowel cleansing, patients were asked to note their stool frequency and consistency daily for 1 week, and throughout the BP according to the modified Bristol stool form scale for children that maximum 5 points represents watery stool description [14]. In the Senna group, data belonging to the last cleansing day was considered statistically when compared with the PEG-B group.…”

A review of feeding intolerance in critically ill children

“…Diarrhea is commonly defined in adults as more than three to five liquid stools per day [36], but in infants, it is normal to pass a semi-liquid stool after each feed, making the definition more difficult. The Bristol stool chart is validated in adults and older children [14], but no validated tool is available in infants and toddlers. Diarrhea can be caused by various non-feed-related factors such as infections (Clostridium difficile) or other microbiomeacquired imbalance due to gut failure, antibiotic use, or fasting/feeding regimen changes and shock states and hypoalbunemia [36,47].…”

Gut microbiota influences low fermentable substrate diet efficacy in children with irritable bowel syndrome

“…Every stool passed during the oneweek period, including those submitted for analysis (see below) were characterized by the children using the validated modified pediatric Bristol stool form chart. 32,34 Children were subtyped based on stool form as having IBS-constipation (hard ⩾5% and loose ⩽25% of the time), IBS-diarrhea (hard ⩽25% and loose ⩾25%), IBS-mixed (hard or loose ⩾25%), or IBS-untyped (does not meet criteria for IBS-C, IBS-D, or IBS-M).…”