Defecation frequency and stool form in a coastal eastern Indian population

J Neurogastroenterol Motil. 2013 Jul;19(3):374-80. doi: 10.5056/jnm.2013.19.3.374. Epub 2013 Jul 8.

Abstract

Background/aims: Data on normal stool form and frequency, which are important for defining constipation, are scanty; hence, we studied these in an eastern Indian population.

Methods: One thousand and two hundred apparently healthy asymptomatic subjects were evaluated for predominant stool form (Bristol chart with descriptor) and frequency. Data on demographic and life-style (diet and physical activity) were collected.

Results: Of 1,200 subjects (age 42 ± 14.5 years, 711, 59% male), most passed predominantly Bristol type IV stool (699 [58.2%]; other forms were: type I (23 [1.9%]), type II (38 [3.2%]), type III (99 [8.2%]), type V (73 [6%]), type VI (177 [14.7%]), type VII (7 [0.6%]) and an irregular combination (84 [7%]). Weekly stool frequency was 12.1 ± 4.7 (median 14, range 2-42). Less than 3 stools/week was noted in 32/1,200 (2.6%). Female subjects (n = 489) passed stools less frequently than males (n = 711) (11.1 ± 5.6/week vs. 12.8 ± 3.8/week, P < 0.001) and tended to pass harder forms (type I: 17, type II: 20, type III: 39 vs. 6, 18 and 60, respectively, P = 0.061). Vegetarians (n = 252) and physically active (n = 379) subjects tended to pass stool more frequently than occasional (n = 553) and regular non-vegetarian (n = 395) (11.8 ± 4.5 and 12.8 ± 4.7 vs. 11.3 ± 4.7; P < 0.05) and sedentary (n = 464) and intermediately active (n = 357) subjects (13.4 ± 4.0 and 12.3 ± 4.5 vs. 10.9 ± 5.1, P = 0.080) in different age groups, respectively. Older age was associated with less frequent stool, particularly among female population. Female gender and age > 35 years were significant on multivariate analysis.

Conclusions: Median stool frequency in the studied population was 14/week (range 2-42) and predominant form was Bristol type IV. Older age was associated with lesser stool frequency, particularly among female subjects.

Keywords: Constipation; Functional gastrointestinal disorder; Gastrointestinal transit; Irritable bowel syndrome.