Instrument template · GastroenterologyUpdated September 28, 2026

Bristol Stool Scale diary that participants will actually fill in

Seven stool types, recorded per bowel movement or once a day on the participant's phone. Private, quick and structured, so stool form can become an endpoint instead of an anecdote.

  • Types 1 to 7
  • Private phone diary
  • Daily or per movement

Free sandbox · No credit card · 21 CFR Part 11 aligned

Bowel diary

Today · Movement 2

Which type best describes this stool?

Type 1 Separate hard lumpsType 2 Lumpy, sausage-shapedType 3 Sausage with cracksType 4 Smooth, soft sausageType 5 Soft blobs, clear edgesType 6 Mushy, ragged edgesType 7 Watery, no solid pieces

Urgency

NoneSomeSevere
Recorded privately on their own phone

At a glance

  • The Bristol Stool Form Scale describes seven stool types, from separate hard lumps (type 1) to entirely liquid (type 7). It was developed by Lewis and Heaton and published in 1997.
  • Types 1 and 2 suggest slow transit and constipation, 3 and 4 are typically considered normal, and 5 to 7 suggest faster transit and diarrhoea.
  • In trials it is recorded in a daily bowel diary, often alongside frequency, straining, urgency and abdominal pain.
  • IBS trials commonly use stool consistency as part of responder definitions, for example in IBS with diarrhoea or constipation.
  • Because the topic is sensitive, a private phone diary gets better data than asking at the visit.

Use in trials

From stool chart to endpoint

Gastrointestinal trials in irritable bowel syndrome, chronic constipation, inflammatory bowel disease, microbiome interventions and some oncology supportive care studies all need a reliable record of bowel habit. The Bristol scale gives that record a common language: instead of "loose" or "normal", each movement gets a type number that can be counted and compared.

Endpoints are usually built from daily data: the proportion of days with type 6 or 7 stools, the number of complete spontaneous bowel movements per week, or a weekly responder definition combining stool form with abdominal pain. Those endpoints need daily entries, which is why the diary format and compliance matter more than the scale itself.

Per movement or once a day?

Recording every bowel movement gives the richest data but is more demanding. A once-daily diary asking for the number of movements and the most typical type is often enough. Choose based on your endpoint definition, and keep it the same throughout.

Pictures and privacy

Participants often find the scale easier with illustrations; if you use them, use an approved version and keep the text descriptions. A phone diary lets participants record privately, at the time, rather than recalling details at a clinic visit.

Weekly bowel summary · Subject 009-0007

Movements

11

Type 6-7 days

1

Diary days

7/7

Type 1-2 (hard)1/11
Type 3-59/11
Type 6-7 (loose)1/11

In Capture

A recurring diary with reminders and windows

The Bristol diary runs as a recurring questionnaire in the participant's phone browser, with a daily completion window and reminders that respect quiet hours. The dashboard shows compliance, so missed days are followed up before a weekly responder calculation is compromised.

  • Daily recurring schedule, no app.
  • Reminders when due and before the window closes.
  • Pairs with the GI symptoms diary template.
GI symptoms template
Daily evening diary · Visit 1 to Visit 15
Recurring diaryDaily18:00 to 24:00Hard window
D1✓
D2✓
D3✓
D4✓
D5✓
D6Missed
D7✓
D8✓
D9✓
D10✓
D11✓
D12✓
D13Open
D14
Compliance, last 14 days92%

Try the bowel diary on your phone

Build it in the free sandbox and complete a test entry.

Use the Bristol template free

Endpoints

Composite bowel endpoints built from daily data

Regulatory guidance for irritable bowel syndrome trials uses composite weekly responder definitions that combine abdominal pain with a bowel measure: stool consistency (for example days with type 6 or 7 stools) in diarrhoea-predominant IBS, and complete spontaneous bowel movements in constipation-predominant IBS. A participant is a responder in a week if both criteria are met, and an overall responder if they respond in enough of the treatment weeks.

Those definitions need the daily diary to capture the right fields: stool type, whether the bowel movement was spontaneous (no laxative in the preceding period), whether evacuation felt complete, and daily worst abdominal pain. Build the diary from the endpoint definition backwards, and keep the questions identical for the whole study.

Before go-live

Bowel diary checklist

Endpoint definition written first

Diary fields derived from it.

Rescue laxative recorded

Needed to classify spontaneous movements.

Abdominal pain item

Worst pain in the last 24 hours on a 0 to 10 scale.

Minimum diary days

Per week, for a week to count.

Baseline period

Long enough to establish usual bowel habit.

Illustrations approved

If used, an approved version of the scale.

FAQ

Questions about this template

Something not covered here? Ask us directly.

What is a complete spontaneous bowel movement?

A bowel movement without laxative use in the preceding period (commonly 24 hours) that gives a feeling of complete evacuation. It is the key bowel measure in constipation trials.

How long should the baseline diary run?

Long enough to establish usual bowel habit and confirm eligibility, often around two weeks. The protocol sets the exact period and the minimum number of diary days.

What is the Bristol Stool Scale?

A seven-type classification of stool form, from separate hard lumps (type 1) to entirely liquid (type 7).

Which Bristol types are normal?

Types 3 and 4 are typically considered normal; 1 and 2 suggest constipation and 5 to 7 suggest diarrhoea.

How is it used in IBS trials?

In daily diaries, often combined with abdominal pain in weekly responder definitions.

Should every bowel movement be recorded?

It depends on the endpoint. Per-movement recording is richest; a daily summary is less burdensome.

Is the template free?

Yes, in the free sandbox.

Bowel habit data you can count

Private, daily, structured. Free sandbox.

Use the Bristol template free