Original Article
Stool Consistency, but Not Frequency, Correlates with Total Gastrointestinal Transit Time in Children

https://doi.org/10.1016/j.jpeds.2012.11.082Get rights and content

Objectives

To evaluate the correlation between stool characteristics (consistency and frequency) and gut transit time in children and to determine whether the Bristol Stool Form Scale is a reliable method of assessing intestinal transit rate in children.

Study design

From March 2011 to March 2012, 44 children (25 boys and 19 girls, mean age 7.8 years) with a diagnosis of functional constipation and 36 healthy, nonconstipated children (17 boys and 19 girls, mean age 7.6 years) were enrolled. All participants maintained a 1-week stool diary, recording the time and date of every bowel movement and stool form, and then completed a validated questionnaire on functional constipation according to Rome III criteria. Whole gut transit time (WGTT) was then assessed using the radiopaque markers test.

Results

There was a significant correlation between stool form and WGTT in both constipated and nonconstipated children (correlation coefficient −0.84, P < .001). By contrast, there was no correlation between either stool frequency and WGTT or stool frequency and stool form. Multivariate logistic regression analysis, using WGTT as a dependent variable, showed that the sole variable significantly associated with WGTT was stool form (regression coefficient 2.9, OR 18.4, 95% CI 5.4-62.5, P < .001).

Conclusion

In this prospective, observational, case-control study, we show that stool form, as measured by the Bristol Stool Form Scale, rather than stool frequency, correlates with WGTT in both constipated and nonconstipated children.

Section snippets

Methods

A prospective, observational, case-control study was conducted in 80 consecutive children (42 boys and 38 girls, mean ± SD age 7.7 ± 3.3 years, age range 4-15.4 years) referred to the Department of Pediatrics of the University of Naples “Federico II” from March 2011 to March 2012.

The case group was composed of 44 consecutive patients affected by functional constipation (25 boys and 19 girls, mean ± SD age 7.8 ± 3.3 years, age range 4-15.4 years), defined using Rome III criteria.10 The control

Results

All enrolled children completed the study. Study groups were well matched with respect to age and sex (Table II). Mean WGTT, measured by ROMs, was 63.4 hours for constipated children compared with 30.1 hours for healthy children (P < .001). Constipated children presented a mean weekly BM frequency of 4.8 compared with 5.7 for nonconstipated children (P < .001). The average BSFS score was 3.1 for constipated children compared with a score of 4.2 for nonconstipated children (P < .001). There was

Discussion

Stool form, rather than stool frequency, correlates with WGTT in children. The BSFS should be considered as a valuable tool for evaluating stool form in children. Bekkali et al7 tried to develop a scale useful to describe and differentiate physiologic and pathologic stool appearances in infants, but they were not able to correlate this stool form scale with colonic transit time. Lane et al6 proposed that a modified BSFS, decreasing the number of stool categories from 7 to 5, should be used in

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  • Cited by (0)

    The authors declare no conflicts of interest.

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