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

Abstract

PurposeRome criteria are considered the gold standard for diagnosing functional constipation. The modified Bristol stool form scale (m-BSFS) was validated to measure stool form in children. However, neither the potential use of the m-BSFS as a tool to facilitate the diagnosis of potential constipation, nor the agreement between m-BSFS and stool consistency by Rome has been studied. Our objective is to determine if m-BSFS is a reliable tool to facilitat detection of constipation; and the agreement between stool form by m-BSFS and hard stool criteria in Rome.MethodsA survey tool with the Rome III criteria and the m-BSFS was developed. A Likert-scale addressed frequency of each stool form on the m-BSFS. Responses to Rome III and m-BSFS were compared.ResultsThe sensitivity and specificity of the m-BSFS was 79.2% and 66.0% respectively; and in children <4 years. improved to 81.2% and 75.0% respectively. There was poor agreement between hard stools by m-BSFS and the painful or hard bowel movement question of Rome Criteria.ConclusionThe potential utility of m-BSFS as a reasonably good tool to facilitate the diagnosis of potential constipation in children is shown. The poor agreement between painful or hard stool question in Rome III, and ratings for hard stool on the m-BSFS illustrates that one's perception may differ between a question and a picture. A useful pictorial tool to appraise stool form may, thus, be a favorable complement in the process of enquiry about bowel habits in well-child care.

The P2Y1 Receptor in the Colonic Submucosa of Rats and Its Correlation with Opioid-Induced Constipation

“…Gastrointestinal functions, such as smooth muscle contraction and electrolyte secretion, are controlled by the intrinsic enteric neurons and extrinsic innervation. Intrinsic innervation of the gut is provided by the enteric nervous system, an independent neural network system in the gastrointestinal tract, which mainly includes the submucosal plexus between the mucosa and the submucosa and the myenteric plexus located between the circular muscle and the longitudinal muscle [13,18,[35][36][37]. According to morphological and electrophysiological characteristics, enteric nerve cells can be divided into intrinsic primary afferent or sensory neuron, intermediate nerve cells, and motor nerve cells [13].…”

“…The intrinsic primary afferent nerve cells are the rst neurons in re ex pathways activated by mucosal stimulation. These neurons have cell bodies in the myenteric and submucosal ganglia, and one of the process projecting into the mucosal villi and a second process synapsing with intermediate nerve cells and motor nerve cells in submucosal or myenteric ganglia, and transmits various mechanical and chemical stimulli information to the middle and motor nerve cell body in the intestinal plexus, thereby regulating the gastrointestinal tract smooth muscle movement [13,35,38,39]. MOR is a kind of opioid receptor, which belongs to the G-protein-coupled-receptor family and is widely distributed in enteric nerve cells in the gastrointestinal tract.…”

Pediatric Tuina For Functional Constipation In Children: Study Protocol For A Randomized Controlled Trail

“…Effective rate is the number of participants who are effective (on average, at least one bowel movement in three days, stool softening, defecate unobstructed) divided by total number of the group. Stool form will be measured according to the modi ed Bristol stool form scale (m-BSFS) (Table 3), which classi es the form of children feces into 5 types from separate hard lumps (type 1) to entirely watery (type 5) [35,36]. Distress sensation measured in the range of 0-3 represents the intensity of distress during defecation, "0" means no cry or grimace, "1" means slight cry and grimace, "2" means medium cry and grimace, and "3" means hysterical cry and grimace.…”

Definitions, signs, and symptoms of constipation in people with severe or profound intellectual disabilities: A systematic review

“…The most commonly used clinical definition of constipation is composed by the Rome Diagnostic Criteria (further Rome criteria ) in which the many different forms of expression are represented ( Herz et al., 1996 ; Longstreth et al., 2006 ). The Rome criteria ( Sobrado et al., 2018 ) - consisting of medical history and physical examination - are the gold standard for diagnosing constipation for the general population ( Gulati et al., 2018 ). However, the Rome criteria may have limitations for the use in persons with severe or profound intellectual disabilities ( Coleman and Spurling, 2010 ).…”

“…Furthermore, symptoms such as nausea and abdominal pain are complex to describe and/or communicate for children and adults with severe or profound intellectual disabilities ( Koppen et al., 2017 ). In addition, one of the Rome criteria is ‘bowel movement less than three times a week’; however, a new insight is that the frequency of bowel movement in children with constipation can be even higher than in children without it ( Gulati et al., 2018 ). In accordance with this insight, other authors state that it is more important to investigate deviation from a person's normal frequency of bowel movement and how much effort it takes to relieve ( Enders, 2015 ).…”