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Symptoms Assessment Tools - Constipation

Constipation Score


Constipation is highly common among cancer patients. Malnutrition, poor mobility, decrease oral intake, autonomic failure, and opioid analgesics are all causes of severe constipation. Unfortunately, the problem is often very poorly assessed. Additional methods, other than a history and examination, are occasionally required to assist in adequately assessing the extent of constipation.

The constipation score is one such tool. It consists of a plain, supine x-ray of the abdomen which is then divided into four quadrants. The four quadrants being representative of the ascending, transverse, descending and rectosigmoid colon segments respectively. Each quadrant is assessed for the amount of stool present and is scored from 0 to 3; 0 being the absence of stool and 3 being complete impaction of stool. The scores for each quadrant are totaled. The maximum score being 12 out of 12. A score of 7 or more indicates a more aggressive constipation management is necessary.


Nagaviroj K, Yong WC, Fassbender K, Zhu G, Oneschuk D (2011) “Comparison of the Constipation Assessment Scale and plain abdominal radiography in the assessment of constipation in advanced cancer patients” Journal of Pain & Symptom Management. 42(2):222-8.

Bristol Stool Chart


There are seven types of stools (feces) according to the Bristol Stool Chart. The Bristol Stool Chart or Bristol Stool Scale is a medical aid designed to classify feces into seven groups.



Heaton, K W & Lewis, S J. (1997). Stool form scale as a useful guide to intestinal transit time. Scandinavian Journal of Gastroenterology, 32(9): 920-924.​​