Sunday, August 3, 2008

Output Matter

Output matters

By Stacey Chia

What's your type? A psychologist may 'look' into your head
to gauge if you are a highly driven Type A or have a relaxed
Type B personality.

A gastroenterologist will get straight to the bottom of the
matter by looking at your stool type which can give an idea
of the state of your health.

There is even a seven-point visual indicator - the Bristol Stool
Scale - to tell how long your stool has been in your colon, and
what it can

The seven types on the scale, named after the British university
that came up with it, are:

  • Type 1 - Separate hard lumps, like nuts
  • Type 2 - Sausage-shaped and lumpy
  • Type 3 - Sausage-shaped with cracks
  • Type 4 - Sausage-shaped, smooth and soft
  • Type 5 - Soft blobs, passed out easily
  • Type 6 - Fluffy pieces and mushy
  • Type 7 - Watery with no solid pieces

Types 1 and 2 are considered constipated, while 6 and 7 are under
the diarrhoea group; the normal stools are those that fall under
types 3, 4 and 5.

Dr Yap Chin Kong from Yap Chin Kong Gastroenterology & Liver
Clinic said the scale is useful in that it indicates stool 'transit time'.
A long transit time implies constipation and a short transit time,

Transit time is the time stool stays in the colon before it is passed

'Types 1 and 2 are considered constipated, while 6 and 7 are under
the diarrhoea group; the normal stools are those that fall under
types 3, 4 and 5,' he said.

Dr Gwee Kok Ann, consultant gastroenterologist at Gleneagles
Hospital, said Type 1 stool has a transit time of over 72 hours or
longer, while Type 4 - the ideal - is most easily expelled, with a
transit time of 24 hours.

Dr Yap added that the usual frequency of stool being passed out
ranges from three times a day to once every three days.

While most people only 'go' when they feel the urge, he
believes that people should develop good toilet habit from

This means waking up early, having breakfast, then waiting
for the urge to move the bowels. This will usually occur
within 30 minutes to an hour for many people.

Regular exercise and eating sufficient fruits and vegetables
can help in developing good toilet habit.

'Someone who gets up late and rushes off to school or
work after eating breakfast quickly may develop the
urge but postpone nature's call or not even have the urge
because the mind overrides it,' said Dr Yap.

Not moving the bowels regularly may lead to complications
for the young and very old, Dr Gwee said. A large mass of
stool stuck in the rectum can cause it to overstretch.

'When this happens, the muscle in the rectum's wall loses
its tone. There will then be difficulty contracting the muscle
to evacuate the contents. This usually affects young children
and the elderly,' he added.

He said that, should this happen, it can give rise to abdominal
cramps and vomiting in children.

'As for some elderly patients, stool pellets may actually spill
out without their being aware, while others may develop
ulcers in the rectum arising from the pressure placed on the
wall of the rectum by very hard stools,' he said.

For the layman, the scale comes in handy in noting changes
in bowel patterns.

'If you have experienced a recent change in your bowel pattern
without a clear reason, or if there are alarming signs such as
blood, pain or fever, you should see a doctor,' said Dr Yap.

However, some doctors like Dr Tan Chi Chiu, consultant
gastroenterologist and physician at Gastroenterology &
Medicine International, cautioned against over-reliance on
the scale as a precise gauge of transit time.

'It is not precise. Different people have different grades of
stool for similar transit times,' he explained.

Adapted from:

Fri, Aug 01, 2008
The Straits Times