Bristol Scale?

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Bristol Scale?

Postby smiles » 28 Jul 2013, 08:33

I keep hearing people refer to this and I don't think I know what it means. How do you figure out your bristol scale?
I'm doing mainly self-healing. I went to two doctors, both gave me horrible opinions so for now I am healing this fissure on my own. I might go see a naturopath in a month or so. I have had my fissure for over 5 months now, and just this past month I have noticed big changes. Unfortunately, I have had a few set backs.. I had a week of pain free BMs, and pretty much pain free all day. Just these past two days I have had painful BMs and a little bit of blood :(
Anyways, I'm trying to figure out what happened.. I drank the other day, maybe that's what did it. Who knows. Any advice on the bristol scale would be appreciated!
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Re: Bristol Scale?

Postby WelshDoubleFissure » 28 Jul 2013, 11:22

You can find an example of the Bristol stool scale here.
http://en.m.wikipedia.org/wiki/File:Bristol_stool_chart.svg
Basically 1-3 are not great stools. These generally suggest an unhealthy, unbalanced diet possibly constipation.
Most doctors will tell you to aim (aiming is sometimes difficult to do) for Bristol 4, these are long, thin, soft as easy to pass. As an AF suffererer, these were making me retear over and over. Mine, although soft, were rather large, and this was due to the huge amount of fibre I was consuming. Lots of fibre = big poohs!
I've just had surgery 6 weeks ago and my first stool was a 4 but it hurt like hell. After a week or so of drinking plenty of fluid, overly chewing my food, eating only soluble fibre (google soluble vs insoluble fibre for the difference) and taking Movicol stool softeners 3 times a day, I managed to retain a Bristol 5-6 and I'm still going strong with them now.
If you're in pain whilst passing a stool, try to aim for a BS6 which should be like toothpaste.
You can do this by not eating junk food, eat wheatabix with plenty of fruit, try adding some flaxseed which will give you your fibre intake, prunes, mangos, all veg like broccoli cooked well. Avoid white bread and white rice. Avoid red meat as this doesn't digest easily.
Chew all your food well to make it easier for your tummy to digest it (if you leave big lumps of meat in there, it takes longer to break it all down). Chew chew chew.., and then chew it a bit more.
Drinking 3-5 litres a day, one litre with every meal.
Oh and no alcohol. It's tough but if you want to kick that nasty fissure, it's a small time to give it up for a joyful life.
Hope this helps, find a routine that works for you and stick to it, everyone's different - whatever helps you poop, use it to your advantage.
Take care of your diet and you'll be fine if you're in the early stages. Keep us informed and we're all happy to help with your routines further.
Welsh x
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Re: Bristol Scale?

Postby smiles » 28 Jul 2013, 15:22

Thanks for your advice! I really appreciate it :)
I'm not taking stool softeners at the moment, just magnesium and chlorophyll. My stool is usually soft, but at the beginning it hurts..not too sure why :(.
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Re: Bristol Scale?

Postby Ever the Optimist » 28 Jul 2013, 15:45

Hi Smiles,
Welsh has provided you with some great advice!
I would just add that because that area is obviously very fragile again right now for you, that anything that passes through at this stage is going to cause a little pain or discomfort as soon as it hits that "raw" tear area. You've been suffering for 5 months now, which a CRS would probably diagnose as "chronic". Once a fissure reaches that stage, it takes a lot longer to heal naturally as opposed to healing up pretty quickly within a few weeks. To me, it sounds like you are doing really well despite the recurrence of the bleeding & some pain again - unfortunately healing seems to happen this way and it can take months before you completely & fully heal that tear. It's a bit like being on a rollercoaster with ups and downs and you've just hit a "down" stage possibly but this does not mean that you are not healing!!!! It took me 1 year & 5 months to fully heal with patches like yours in between, so just hang in there and when you go through these lows, be extra vigilant again for a while to ensure you are keeping everything soft soft soft!.......& that means following all the advice above religiously
Another brilliant tip, if you're not already doing so, just insert a dollop of vaseline - a little bit internally into your bottom and around the opening, prior to your BM. It helps lubricate the area and a lot of us swear by doing this.
The Bristol scale is fab! If you're pooping 4's & 5's, you know your diet and fluid intake is pretty much spot on.
Keep perservering and stay positive! Patches like these are normal if you are healing naturally, honestly.........:) 
Chronic Fissure diagnosed December 2011
Healed by Diltiazem around Feb 2013
Anal Fistula followed burst abscess in June 2012
2 internal troublesome piles remain & suspected, but undiagnosed, ongoing Levator Ani type symptoms & flare-ups
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Re: Bristol Scale?

Postby smiles » 28 Jul 2013, 17:07

Wow, thank you ETO! Did you have a lot of setbacks during your 1 year and 5 months? How in the world did you do this for that long? I hope you were blessed with some pain-free months during that time! So happy to hear you have healed naturally from a chronic fissure..that definitely gives me hope.
What treatments did you use? Did you use nitro at all? It's what I'm using now and I don't know if I should continue or try another cream.
Thank you for your supportive words. I feel much better knowing that this is normal to have setbacks!
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Re: Bristol Scale?

Postby Ever the Optimist » 29 Jul 2013, 00:54

Hi Smiles,
Yes, please don't be too discouraged by the return of some pain and bleeding. If the fissure is naturally healing, chances are you will experience this for a few days but will then start to feel better again. It's incredibly frustrating but seems to be the way these things heal and it takes a long time, I'm sorry to say - that's not to say that you may heal quicker than I did anyway.
Yes, I had setbacks too, although nothing as major and painful as the onslaught of the fissure originally - each time, each set back did get a lot better and a lot less painful too until it all reached a stage where it got easier and easier until final healing. The healing, although long, was never as bad as those first few weeks, so it was manageable and I was just happy I wasn't crippled with the pain like before. I think you just become grateful that nothing is as bad as it first was.
I used Diltizem cream, which I believe is as effective as Nitro and this really helped kick in the healing process. I used it for 7 weeks and after that knew things, felt generally better, although I was not healed for a few months after using that. It doesn't heal things directly just allows the muscle to relax so healing can happen.
I really would say hang in there, because for me surgery was the very last option and I was prepared to try anything to heal naturally first and the patience paid off in the end. I absolutely believe that a chronic fissure will heal naturally for a lot of us (although sadly not for some) but you really have to accept the time it might take and change your toilet/ dietary habits for a long long time - I know for life, in my case as I certainly never want a repeat of any of this.
There's a couple of others that have healed this way too - you might want to look out for Marge's success post because that's a reassuring read too - but keep believing in healing. You will get there! All the very best to you :) 
Chronic Fissure diagnosed December 2011
Healed by Diltiazem around Feb 2013
Anal Fistula followed burst abscess in June 2012
2 internal troublesome piles remain & suspected, but undiagnosed, ongoing Levator Ani type symptoms & flare-ups
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Re: Bristol Scale?

Postby PompeyBlue » 29 Jul 2013, 03:33

Hi Smiles
I had my first fissure eight years ago. It healed with diltiazem in about eight weeks and the accompanying skin tag/sentinel pile also vanished. I was completely fissure free for seven years. I lived normally, ate and drank what I liked,walked lots and cycled over 100 miles a week. The only adjustment I made was to eat more fruit and fibre and drink more to keep regular BMs.
Last September I had a recurrence because of constipation caused by a change of unrelated medication. I had completely forgotten the first fissure up till then and went into denial. I tried to ignore it and went on a long cycle ride. Big mistake!
I healed again but because I had to have major stomach surgery for another potentially more serious problem I retore twice because of constipation caused by barium meals, painkillers and so on. I healed again two months ago with nothing but Movicol  (Miralax in the US)and I feel perfectly normal though I am still taking 1/4 sachet of Movicol. The point of all this is to let you know that some of us are fortunate enough to be able to heal without any intervention and that each time I have healed -now four if you count retears.
You have had some great advice already. I would just like to add that AF is a very miserable experience and my approach has been to make as few concessions as possible. I have never given up alcohol nor has any health professional advised me to do so. My advice is to recognise that it is dehydrating and drink plenty of water before, after and eg if wine at the same time
I hope this helps. I have other tips that work for me if you are interested but we are all different.
Best wishes for speedy healing.
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Re: Bristol Scale?

Postby stevestate » 26 Oct 2016, 05:13

Hi there.

I'm 5-months post-surgery with Botox and no sign of healing, seemingly. I'm either 6/7 Bristol (with 3 BMs per day) or a painful 3 turning into an overlong 4 (one BM per day).

My diet is high-fibre, 90% vegetarian, 90% dairy-free. Small amount of alcohol. Docusate stool softeners seemed to stop working after 3 months of 5-a-day. Currently on Dulcolax - one a day which sometimes works but sometimes doesn't.

I'm posting a diary on the topic entitled 'Post-fissurectomy recovery times?' if you want to take a look at my routine in more detail. I think I'm getting too much fibre. What do you think? Could really do with some help...
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