About all

Change in stool caliber: Narrow stools: Should I be concerned?


Why Is My Poop Stringy? 5 Causes of Narrow, Thin Stools

Admit it: You sometimes peek at your poop in the toilet bowl after a bowel movement (BM). Have you ever noticed that your stool is narrow, long, pencil-thin, or stringy?

If your poop is narrow or stringy only once in a while, it’s no big deal. But if it happens often, it may be a sign of certain health problems.

Stringy stool could be a sign of both minor and more serious health conditions, like these:


Constipation is when you poop less than three times a week. It can have many different symptoms. While narrow or pencil-thin stool is not always a sign of constipation, it may be if your poop doesn’t normally look that way.

Constipation is usually caused by a lack of fiber in your diet or not enough exercise. Other causes include pregnancy, travel, use of some medications, and changes in your hormone levels.

When you’re constipated, your stool may be hard, dry, and difficult to pass. It may look lumpy.

Having narrow or pencil-thin BMs on occasion isn’t something to worry about. If it looks that way all the time or it gets narrower over time, it could be a concern, so let your doctor know.

If constipation is the cause of your narrow poop, you might also have these symptoms:

  • Belly cramps or pain
  • Bloating or gas
  • Lack of energy
  • Low appetite
  • Need to strain when you poop
  • Feel like you can’t get all the poop out

Simple constipation treatments include:

  • Add more fiber to your diet, at least 25 grams a day.
  • Eat more whole grains, fresh fruits, and veggies.
  • Get more physical activity.
  • Drink more fluids like water.

You may think that the easy way to treat constipation is to take an over-the-counter laxative. But if you overuse laxatives, it can make things worse. Talk to your doctor before you take any laxative, so you know it’s the right treatment for you.

Colorectal Cancer

If you have stool that’s suddenly stringy or poop that gets pencil-thin over time, does it mean you have cancer? Doctors used to link narrow BMs to colorectal or colon cancer. That’s because they thought that cancer in your colon caused it to become narrower, and your poop would look narrow after it passed through.

Now, they no longer think this is always the case. Gradual narrowing of your stool could be one symptom of colon cancer, but it’s usually the result of other, much less serious conditions.

Ask your doctor if you need to take any tests to rule out colorectal cancer, like a colonoscopy.

If colorectal cancer is the cause of your narrow stool, you might have these other symptoms:

Colon cancer treatments include surgery, radiation, and chemotherapy.

Anal Cancer

Narrow stool could be a sign of another, rare kind of cancer: anal cancer. It’s a cancer that starts in your anus, or the outer part of your rectum where poop comes out.

Poop that changes in shape and becomes narrower is one possible sign of anal cancer, which is usually caused by infection with the human papillomavirus (HPV).

If anal cancer is the cause of your narrow bowel movements, you may have these other symptoms:

  • Pain, a “full” feeling, bleeding, or itching in your rectum
  • Strange rectal discharge
  • Lumps felt around the opening of your anus
  • Swollen lymph nodes around your anus

Anal cancer is usually treated with surgery, radiation, and chemotherapy.

Irritable Bowel Syndrome

Changes in your poop’s shape or size can be a sign of irritable bowel syndrome (IBS). Your stool may look smaller or narrower than normal. Its texture can change. You may have diarrhea, which can look stringy.

If irritable bowel syndrome is the cause of your narrow stool, you might also have these other symptoms:

  • Constipation
  • Gas
  • Bloating
  • Mucus in your poop
  • Strong urge to go
  • Belly cramps that ease after you poop
  • After you poop, you feel like you have to go again

To manage IBS, get more fiber in your diet. Soluble fiber in foods like fresh apples, oranges, and beans can ease constipation and diarrhea. Insoluble fiber in foods like whole grains can bulk up your stool so it passes more normally.

Stress may trigger IBS episodes, so try to find healthy ways to manage stress, like exercise.

Parasitic Gut Infections

Parasites like tiny worms can get into your gut and cause thin, stringy BMs or stringy, loose diarrhea.

These bugs are also called roundworms. They live in the soil and can get into your food, then live in your gut.

Roundworms are more common in hot, humid parts of the world, underdeveloped countries, and places where there is poor sanitation.

If roundworms are the cause of your stringy, thin poop, you may have these other symptoms:

  • Fever
  • Shortness of breath
  • Cough or wheeze
  • Belly pain
  • Nausea
  • Vomiting
  • You see actual worms in your poop

If the worms stick around in your gut for a long time, they can block your bowels. Signs of a blockage are severe belly pain and vomiting. If you have these symptoms, get help from a doctor right away.

Contact your doctor right away if you think you or your child has a parasitic infection or worms. Diarrhea can dehydrate you very quickly.

Your doctor may prescribe the drug albendazole to get rid of the roundworms and their eggs.

Pencil Thin Stools – Symptoms, Causes, Treatments

Changes in the stool can be related to changes in the diet or may be indications of a condition of the digestive tract. Narrowing of the stool may be due to a mass in the colon or rectum that limits the size of the stool that can pass through it. Conditions that cause diarrhea can also cause pencil thin stools.

Persistent pencil thin stool, which may be solid or loose, is one of the symptoms of colorectal polyps or cancer. As the size of the polyp or cancer increases, it can decrease the internal diameter of the colon or rectum so that only thin stool can pass through. Other symptoms can include blood in the stool, abdominal discomfort, and unintended weight loss, particularly in the case of advanced colorectal cancer. Colorectal cancers are diagnosed in about 140,000 people in the United States per year.

Narrowing of the rectum or anus can be caused by enlargement of the prostate in men or may be a complication of anal fissures (tears or cracks), rectal ulcers, Crohn’s disease or ulcerative colitis (inflammatory bowel diseases), or anorectal trauma or surgery.

The loosely formed stools of diarrhea may have a narrow, sometimes ribbon-like appearance. Diarrhea can have a variety of causes; it may go away on its own or become chronic. Diarrhea that is persistent or accompanied by other symptoms may require treatment.

Pencil thin stools that do not resolve within a couple of days or that are associated with other symptoms can be associated with serious conditions.
Seek immediate medical care (call 911) if you have bloody stool, black or tarry stool, stool with pus, severe abdominal pain or cramping, high fever (higher than 101 degrees Fahrenheit), or if you suddenly stop passing stool. If you are having diarrhea, it increases your risk of dehydration, which can have significant complications. Symptoms of dehydration, such as decreased urination, excessive thirst, fatigue, and light-headedness, also require immediate medical care.

If your pencil thin stools are persistent or cause you concern, seek prompt medical care

Healthy Aging: Bowel Habits & Aging | MUSC Health

In case you haven’t noticed, as we age there are a number of things that just aren’t what they used to be. In other words, we can’t or don’t perform at age 70 like we did at age 30. One of those many things that age tends to change is our digestive system. It has been estimated that 40 percent of the elderly will have an age-related digestive problem each year. We don’t have space to go through all the things that change with age in the digestive system, but we will focus on something that tends to go unmentioned in polite company – your bowel habits. Nevertheless, sometimes socially uncomfortable topics must be addressed.

What is Normal?

The first thing to understand is that what goes in is supposed to come out – albeit in a very different form and with some nutrients missing. We eat and drink to sustain our bodies and after the digestive system extracts the necessary ingredients from our ingestion, the wastes are excreted as liquids in urine and solids in feces.

Normal bowel movements are highly variable between individuals in terms of frequency and in terms of form (see the figure below). People have “normal” frequency of from three times a day (usually after each meal) to one every other day. Thus is it is normal for humans to have highly variable habits, but each one of us tends to have a regular habit of bowel evacuation – most commonly, one per day and usually at about the same time of day.

With apologies to all who find the Bristol Stool Chart (below) offensive (only the English would concoct such a device to communicate the non-mentionable), the normal consistency of stool is soft or firm (Types 2-4) and not brick hard or watery loose (Types 1 and 5-6). Consistency changes more than frequency in each of us. (Dear reader, I know this is more than you want to know, but there is a reason to cover this as we age.)

What Bowel Habit Changes Come with Aging?

As stated at the outset, as we age things change, and this includes bowel habits. The most common thing to happen with age is that constipation is more frequent. Constipation is usually defined as less frequent bowel movements (two or fewer per week), straining at time of defecation at least 25 percentage of the time, often incomplete evacuation (meaning returning to complete the process in an hour or so), and a hard stool (Bristol Type 1 or 2).

This happens due to a number of factors related to age. These include: lack of muscle tone in the bowel and abdominal muscles, slowed peristalsis (involuntary contraction of the intestinal muscles), lack of exercise, immobility (sedentary life style or travel), inadequate fluid intake, too many dairy products, lack of dietary fiber (fruits and vegetables), and many medicines. Some of the medicines that predispose to constipation are calcium channel blockers, narcotic pain meds, antacids containing calcium or aluminum, iron, anti-depressants, and overuse and/or abrupt stoppage of laxatives.

The home treatment of constipation is to tend to any of the known causes, for example, if one is not staying hydrated by drinking eight glasses of water a day, then do so. Eat foods rich in fiber including the old stand-by prunes. Consume bread with whole grains and cereals. Eat dairy products in moderation, and avoid fried fast foods. Exercise more than usual and even try some sit-ups to improve abdominal muscle tone. Only your physician should recommend a laxative as these may be problematic in constipation. Stool softeners may be used as recommended.

It is also normal as we age to have diarrhea from time to time – not because of aging per se, but because we can eat foods that “disagree” with us, ingest some infected food product, contract a “GI virus” or the intestinal flu, perform extensive exercise with rampant fluid consumption, or due to food allergies. Mild diarrhea can be waited out or over-the-counter medications like Pepto-Bismol, Imodium A-D, or Kaopectate may be taken. Diarrhea should not last more than 1-3 days from any of the above. If it does, get medical attention.

What Are Abnormal Bowel Habit Changes?

There are a number of changes in our bowel habits that could be harbingers of diseases that need to be identified and treated. One of the possible signs of bowel cancer is a change in the caliber of stool. If it becomes “pencil thin” and persists for a week or two and clearly is a change from your normal, this should be reported to your physician. If weight loss accompanies constipation, or fever is a part of diarrhea, these are warning signs of potentially serious gastrointestinal disease. Blood, either red or dark black, is abnormal and needs evaluation. Constipation can be a manifestation of many diseases including depression, hypothyroidism, Parkinson’s disease, and cancer. Diarrhea may be a symptom of Crohn’s disease, ulcerative colitis, hyperthyroidism, malabsorption disorders, and food allergies. All of these potential abnormal conditions require a thorough evaluation.

The Bottom Line

As unsavory as it may seem, paying attention to our bowel habits and excrement is something we must do to retain optimal health. If there are significant changes that persist for two or three weeks, consult your physician.

5 Facts You Need to Know – Cleveland Clinic

Contributor: I. Emre Gorgun, MD

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Your bowels communicate.

That may sound strange, but here’s what I mean: Signs of everything from diseases to stress may show up in your bathroom habits. The key is knowing what to look for — and what the signs may mean.

1. There is no normal

People are different. So are bowel movements. The size, shape and consistency of feces will change greatly from person to person.

Instead of looking for “normal,” look for a change. Did you use to move your bowels frequently but now have trouble doing so? Did they use to be solid but now are runny for a long period of time? When you experience a big, noticeable change that lasts, it’s time to see your doctor.

2. Blood is a warning sign

If there is blood in your feces on a recurring basis, see a doctor. Blood can be a sign of polyps or colorectal cancer. It also can be caused by benign conditions such as hemorrhoids and anal fissures. In any case, it’s worth getting checked out.

If you see blood, keep an eye out for other symptoms: weight loss, fever, chills. When they come together, those are “high-alert” symptoms of bowel disorders.

3. Sometimes size is a concern

If you used to have sizeable stools but now they are always pencil thin and hard to pass, consult your doctor. In certain types of colon cancer, the bowel gets narrow, and so do your bowel movements.

Thin stools do not automatically mean cancer. But if they last a long time and if going to the bathroom is difficult for you, your doctor may order a colonoscopy to rule it out.

4. Consistency matters

We all have bouts of diarrhea from time to time. Runny, watery stool over a short period of time can mean mild food poisoning or an infection, for example.

But if you used to have solid bowel movements and now have diarrhea frequently, it could be a sign of an inflammatory bowel disease such as Crohn’s disease or ulcerative colitis — especially if it comes with other symptoms such as abdominal pain, blood and weight loss.

5. It could be stress

Your body reacts to things that go on around us. The impact of stress and unresolved issues may show up in your bathroom.

Your bowels may be indicating something that you’re not appreciating consciously. If your bathroom habits have changed drastically and other medical causes have been excluded, life’s stresses may be to blame.

Pay attention to what your bowels are telling you. From stress to medical conditions, they may give you warning signs that will help you improve your health.

Villous Adenoma Clinical Presentation: History, Physical, Causes

  • Ferlitsch M, Reinhart K, Pramhas S, et al. Sex-specific prevalence of adenomas, advanced adenomas, and colorectal cancer in individuals undergoing screening colonoscopy. JAMA. 2011 Sep 28. 306(12):1352-8. [Medline].

  • Fairley KJ, Li J, Komar M, Steigerwalt N, Erlich P. Predicting the risk of recurrent adenoma and incident colorectal cancer based on findings of the baseline colonoscopy. Clin Transl Gastroenterol. 2014 Dec 4. 5:e64. [Medline].

  • Wark PA, Wu K, van ‘t Veer P, Fuchs CF, Giovannucci EL. Family history of colorectal cancer: a determinant of advanced adenoma stage or adenoma multiplicity?. Int J Cancer. 2009 Jul 15. 125(2):413-20. [Medline].

  • Terhaar Sive Droste JS, Craanen ME, et al. Colonoscopic yield of colorectal neoplasia in daily clinical practice. World J Gastroenterol. 2009 Mar 7. 15(9):1085-92. [Medline]. [Full Text].

  • Martinez ME, Baron JA, Lieberman DA, et al. A pooled analysis of advanced colorectal neoplasia diagnoses after colonoscopic polypectomy. Gastroenterology. 2009 Mar. 136(3):832-41. [Medline].

  • de Jonge V, Sint Nicolaas J, van Leerdam ME, Kuipers EJ, Veldhuyzen van Zanten SJ. Systematic literature review and pooled analyses of risk factors for finding adenomas at surveillance colonoscopy. Endoscopy. 2011 Jul. 43(7):560-72. [Medline].

  • Denis B, Peters C, Chapelain C, et al. Diagnostic accuracy of community pathologists in the interpretation of colorectal polyps. Eur J Gastroenterol Hepatol. 2009 Oct. 21(10):1153-60. [Medline].

  • Bokemeyer B, Bock H, Huppe D, et al. Screening colonoscopy for colorectal cancer prevention: results from a German online registry on 269000 cases. Eur J Gastroenterol Hepatol. 2009 Jun. 21(6):650-5. [Medline].

  • Cole BF, Logan RF, Halabi S, et al. Aspirin for the chemoprevention of colorectal adenomas: meta-analysis of the randomized trials. J Natl Cancer Inst. 2009 Feb 18. 101(4):256-66. [Medline].

  • Baron JA, Cole BF, Sandler RS, et al. A randomized trial of aspirin to prevent colorectal adenomas. N Engl J Med. 2003 Mar 6. 348(10):891-9. [Medline].

  • Bond JH. Colon polyps and cancer. Endoscopy. 2001 Jan. 33(1):46-54. [Medline].

  • Bond JH. Polyp guideline: diagnosis, treatment, and surveillance for patients with colorectal polyps. Practice Parameters Committee of the American College of Gastroenterology. Am J Gastroenterol. 2000 Nov. 95(11):3053-63. [Medline].

  • Bond JH. Polyp guideline: diagnosis, treatment, and surveillance for patients with nonfamilial colorectal polyps. The Practice Parameters Committee of the American College of Gastroenterology. Ann Intern Med. 1993 Oct 15. 119(8):836-43. [Medline].

  • Cotton PB, Durkalski VL, Pineau BC, et al. Computed tomographic colonography (virtual colonoscopy): a multicenter comparison with standard colonoscopy for detection of colorectal neoplasia. JAMA. 2004 Apr 14. 291(14):1713-9. [Medline].

  • Day DW, Morson BC. The adenoma-carcinoma sequence. Morson BC, ed. The Pathogenesis of Colorectal Cancer. Philadelphia: WB Saunders; 1978. 58-71.

  • DuBois RN, Giardiello FM, Smalley WE. Nonsteroidal anti-inflammatory drugs, eicosanoids, and colorectal cancer prevention. Gastroenterol Clin North Am. 1996 Dec. 25(4):773-91. [Medline].

  • Farnell MB, Sakorafas GH, Sarr MG, et al. Villous tumors of the duodenum: reappraisal of local vs. extended resection. J Gastrointest Surg. 2000 Jan-Feb. 4(1):13-21, discussion 22-3. [Medline].

  • Gibbs ER, Walton GF, Kent RB 3rd, Laws HL. Villous tumors of the ampulla Vater. Am Surg. 1997 Jun. 63(6):467-71. [Medline].

  • Itzkowitz SH, Kim YS. Colonic polyps and polyposis syndromes. Feldman M, Scharschmidt BF, Sleisenger MH, eds. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, and Management. 6th ed. Philadelphia: WB Saunders; 1997. 467-71.

  • Mandel JS, Bond JH, Church TR, et al. Reducing mortality from colorectal cancer by screening for fecal occult blood. Minnesota Colon Cancer Control Study. N Engl J Med. 1993 May 13. 328(19):1365-71. [Medline].

  • Morson BC, Dawson IMP. Gastrointestinal Pathology. Oxford: Blackwell Scientific; 1972.

  • Pickhardt PJ, Choi JR, Hwang I, et al. Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. N Engl J Med. 2003 Dec 4. 349(23):2191-200. [Medline].

  • Sandler RS, Halabi S, Baron JA, et al. A randomized trial of aspirin to prevent colorectal adenomas in patients with previous colorectal cancer. N Engl J Med. 2003 Mar 6. 348(10):883-90. [Medline].

  • Schrock TR. Colonoscopy for colorectal cancer: too much, too little, just right. ASGE Distinguished Lecture 1993. Gastrointest Endosc. 1993 Nov-Dec. 39(6):848-51. [Medline].

  • Seitz U, Bohnacker S, Seewald S, et al. Is endoscopic polypectomy an adequate therapy for malignant colorectal adenomas? Presentation of 114 patients and review of the literature. Dis Colon Rectum. 2004 Nov. 47(11):1789-96; discussion 1796-7. [Medline].

  • Stryker SJ, Wolff BG, Culp CE, Libbe SD, Ilstrup DM, MacCarty RL. Natural history of untreated colonic polyps. Gastroenterology. 1987 Nov. 93(5):1009-13. [Medline].

  • Winawer SJ, Zauber AG, Fletcher RH, et al. Guidelines for colonoscopy surveillance after polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society. Gastroenterology. 2006 May. 130(6):1872-85. [Medline].

  • Winawer SJ, Zauber AG, Ho MN, et al. Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup. N Engl J Med. 1993 Dec 30. 329(27):1977-81. [Medline].

  • Winawer SJ, Zauber AG, Ho MN, et al. The National Polyp Study. Eur J Cancer Prev. 1993 Jun. 2 Suppl 2:83-7. [Medline].

  • Winawer SJ, Zauber AG, O’Brien MJ, et al. Randomized comparison of surveillance intervals after colonoscopic removal of newly diagnosed adenomatous polyps. The National Polyp Study Workgroup. N Engl J Med. 1993 Apr 1. 328(13):901-6. [Medline].

  • Zauber AG, Winawer SJ. Initial management and follow-up surveillance of patients with colorectal adenomas. Gastroenterol Clin North Am. 1997 Mar. 26(1):85-101. [Medline].

  • Jeong YH, Kim KO, Park CS, Kim SB, Lee SH, Jang BI. Risk factors of advanced adenoma in small and diminutive colorectal polyp. J Korean Med Sci. 2016 Sep. 31(9):1426-30. [Medline].

  • Most bowel cancer symptoms do not indicate colorectal cancer and polyps: a systematic review | BMC Gastroenterology

  • 1.

    Cooper N, Westlake S: Cancer incidence and mortality: trends in the United Kingdom and constituent countries, 1993 to 2004. Health Statistics Quarterly. 2008, Summer (38): 33-46.

    Google Scholar 

  • 2.

    Majumdar SR, Fletcher RH, Evans AT: How does colorectal cancer present? Symptoms, duration, and clues to location. Am J Gastroenterol. 1999, 94 (10): 3039-3045. 10.1111/j.1572-0241.1999.01454.x.


    Google Scholar 

  • 3.

    Mulcahy HE, O’Donoghue DP: Duration of colorectal cancer symptoms and survival: the effect of confounding clinical and pathological variables. Eur J Cancer. 1997, 33 (9): 1461-1467. 10.1016/S0959-8049(97)00089-0.


    Google Scholar 

  • 4.

    Dent OF, Goulston KJ, Zubrzycki J, Chapuis PH: Bowel symptoms in an apparently well population. Dis Colon Rectum. 1986, 29 (4): 243-247. 10.1007/BF02553027.


    Google Scholar 

  • 5.

    Goulston K, Chapuis P, Dent O, Bokey L: Significance of bowel symptoms. Med J Aust. 1987, 146 (12): 631-633.


    Google Scholar 

  • 6.

    European Panel on the Appropriateness of Gastrointestinal Endoscopy II (EPAGE). 2008, Lausanne, Switzerland, 2009:

  • 7.

    Dodds S, Dodds A, Vakis S, Flashman K, Senapati A, Cripps N, Thompson M: The value of various factors associated with rectal bleeding in the diagnosis of colorectal cancer. Gut. 1999, 44 (suppl 1): A99-

    Google Scholar 

  • 8.

    Norrelund N, Norrelund H: Colorectal cancer and polyps in patients aged 40 years and over who consult a GP with rectal bleeding. Fam Pract. 1996, 13 (2): 160-165. 10.1093/fampra/13.2.160.


    Google Scholar 

  • 9.

    Moses LE, Shapiro D, Littenberg B: Combining independent studies of a diagnostic test into a summary ROC curve: data-analytic approaches and some additional considerations. Stat Med. 1993, 12 (14): 1293-1316. 10.1002/sim.4780121403.


    Google Scholar 

  • 10.

    Rutter CM, Gatsonis CA: Regression methods for meta-analysis of diagnostic test data. Acad Radiol. 1995, 2 (Suppl 1): S48-56.


    Google Scholar 

  • 11.

    Rutter CM, Gatsonis CA: A hierarchical regression approach to meta-analysis of diagnostic test accuracy evaluations. Stat Med. 2001, 20 (19): 2865-2884. 10.1002/sim.942.


    Google Scholar 

  • 12.

    Macaskill P: Empirical Bayes estimates generated in a hierarchical summary ROC analysis agreed closely with those of a full Bayesian analysis. J Clin Epidemiol. 2004, 57 (9): 925-932. 10.1016/j.jclinepi.2003.12.019.


    Google Scholar 

  • 13.

    Adler A, Roll S, Marowski B, Drossel R, Rehs H-U, Willich SN, Riese J, Wiedenmann B, Rosch T: Appropriateness of colonoscopy in the era of colorectal cancer screening: a prospective, multicenter study in a private-practice setting (Berlin Colonoscopy Project 1, BECOP 1). Dis Colon Rectum. 2007, 50 (10): 1628-1638. 10.1007/s10350-007-9029-y.


    Google Scholar 

  • 14.

    Ahmed S, Leslie A, Thaha MA, Carey FA, Steele RJ: Lower gastrointestinal symptoms are not predictive of colorectal neoplasia in a faecal occult blood screen-positive population. Br J Surg. 2005, 92 (4): 478-481. 10.1002/bjs.4879.


    Google Scholar 

  • 15.

    Bafandeh Y, Khoshbaten M, Eftekhar Sadat A-T, Farhang S: Clinical predictors of colorectal polyps and carcinoma in a low prevalence region: results of a colonoscopy based study. World J Gastroenterol. 2008, 14 (10): 1534-1538. 10.3748/wjg.14.1534.

    PubMed Central 

    Google Scholar 

  • 16.

    Bat L, Pines A, Shemesh E, Levo Y, Zeeli D, Scapa E, Rosenblum Y: Colonoscopy in patients aged 80 years or older and its contribution to the evaluation of rectal bleeding. Postgrad Med J. 1992, 68 (799): 355-358. 10.1136/pgmj.68.799.355.

    PubMed Central 

    Google Scholar 

  • 17.

    Berkowitz I, Kaplan M: Indications for colonoscopy. An analysis based on indications and diagnostic yield. S Afr Med J. 1993, 83 (4): 245-248.


    Google Scholar 

  • 18.

    Bhatti MA, Kashif MA, Imran M: Colonoscopic evaluation of middle aged patients with altered bowel habits. Journal of the College of Physicians and Surgeons – Pakistan. 2004, 14 (8): 481-484.


    Google Scholar 

  • 19.

    Bjerregaard NC, Tottrup A, Sorensen HT, Laurberg S: Diagnostic value of self-reported symptoms in Danish outpatients referred with symptoms consistent with colorectal cancer. Colorectal Dis. 2007, 9 (5): 443-451. 10.1111/j.1463-1318.2006.01170.x.


    Google Scholar 

  • 20.

    Brenna E, Skreden K, Waldum HL, Marvik R, Dybdahl JH, Kleveland PM, Sandvik AK, Halvorsen T, Myrvold HE, Petersen H: The benefit of colonoscopy. Scand J Gastroenterol. 1990, 25 (1): 81-88. 10.3109/00365529008999213.


    Google Scholar 

  • 21.

    Brewster NT, Grieve DC, Saunders JH: Double-contrast barium enema and flexible sigmoidoscopy for routine colonic investigation. Br J Surg. 1994, 81 (3): 445-447. 10.1002/bjs.1800810341.


    Google Scholar 

  • 22.

    Chak A, Post AB, Cooper GS: Clinical variables associated with colorectal cancer on colonoscopy: a prediction model. Am J Gastroenterol. 1996, 91 (12): 2483-2488.


    Google Scholar 

  • 23.

    Charalambopoulos A, Syrigos KN, Ho JL, Murday VA, Leicester RJ: Colonoscopy in symptomatic patients with positive family history of colorectal cancer. Anticancer Res. 2000, 20 (3B): 1991-1994.


    Google Scholar 

  • 24.

    Cheong KL, Roohi S, Jarmin R, Sagap I, Tong SH, Qureshi A: The yield for colorectal cancer and adenoma by indication at colonoscopy. Med J Malaysia. 2000, 55 (4): 464-466.


    Google Scholar 

  • 25.

    Curless R, French J, Williams GV, James OF: Comparison of gastrointestinal symptoms in colorectal carcinoma patients and community controls with respect to age. Gut. 1994, 35 (9): 1267-1270. 10.1136/gut.35.9.1267.

    PubMed Central 

    Google Scholar 

  • 26.

    de Bosset V, Froehlich F, Rey JP, Thorens J, Schneider C, Wietlisbach V, Vader JP, Burnand B, Muhlhaupt B, Fried M, Gonvers JJ: Do explicit appropriateness criteria enhance the diagnostic yield of colonoscopy?. Endoscopy. 2002, 34 (5): 360-368. 10.1055/s-2002-25277.


    Google Scholar 

  • 27.

    Douek M, Wickramasinghe M, Clifton MA: Does isolated rectal bleeding suggest colorectal cancer?. Lancet. 1999, 354 (9176): 393-


    Google Scholar 

  • 28.

    du Toit J, Hamilton W, Barraclough K: Risk in primary care of colorectal cancer from new onset rectal bleeding: 10 year prospective study. BMJ. 2006, 333 (7558): 69-70. 10.1136/bmj.38846.684850.2F.

    PubMed Central 

    Google Scholar 

  • 29.

    Dukas L, Willett WC, Colditz GA, Fuchs CS, Rosner B, Giovannucci EL: Prospective study of bowel movement, laxative use, and risk of colorectal cancer among women. Am J Epidemiol. 2000, 151 (10): 958-964.


    Google Scholar 

  • 30.

    Duncan JE, Sweeney WB, Trudel JL, Madoff RD, Mellgren AF, Duncan JE, Sweeney WB, Trudel JL, Madoff RD, Mellgren AF: Colonoscopy in the elderly: low risk, low yield in asymptomatic patients. Dis Colon Rectum. 2006, 49 (5): 646-651. 10.1007/s10350-005-0306-3.


    Google Scholar 

  • 31.

    Ellis BG, Thompson MR: Factors identifying higher risk rectal bleeding in general practice. Br J Gen Pract. 2005, 55 (521): 949-955.

    PubMed Central 

    Google Scholar 

  • 32.

    Farrands PA, Hardcastle JD: Colorectal screening by a self-completion questionnaire. Gut. 1984, 25 (5): 445-447. 10.1136/gut.25.5.445.

    PubMed Central 

    Google Scholar 

  • 33.

    Ferraris R, Senore C, Fracchia M, Sciallero S, Bonelli L, Atkin WS, Segnan N, Score Working Group I: Predictive value of rectal bleeding for distal colonic neoplastic lesions in a screened population. Eur J Cancer. 2004, 40 (2): 245-252. 10.1016/j.ejca.2003.08.002.


    Google Scholar 

  • 34.

    Fijten GH, Starmans R, Muris JW, Schouten HJ, Blijham GH, Knottnerus JA: Predictive value of signs and symptoms for colorectal cancer in patients with rectal bleeding in general practice. Fam Pract. 1995, 12 (3): 279-286. 10.1093/fampra/12.3.279.


    Google Scholar 

  • 35.

    Fontagnier EM, Manegold BC: [Colonoscopy in patients over 80 years of age. Indications, methods and results]. Dtsch Med Wochenschr. 2000, 125 (44): 1319-1322. 10.1055/s-2000-8078.


    Google Scholar 

  • 36.

    Haenszel W, Berg JW, Segi M, Kurihara M, Locke FB: Large-bowel cancer in Hawaiian Japanese. J Natl Cancer Inst. 1973, 51 (6): 1765-1779.


    Google Scholar 

  • 37.

    Hamilton W, Round A, Sharp D, Peters TJ: Clinical features of colorectal cancer before diagnosis: a population-based case-control study. Br J Cancer. 2005, 93 (4): 399-405. 10.1038/sj.bjc.6602714.

    PubMed Central 

    Google Scholar 

  • 38.

    Higginson J: Etiological factors in gastrointestinal cancer in man. J Natl Cancer Inst. 1966, 37 (4): 527-545.


    Google Scholar 

  • 39.

    Jacobs EJ, White E: Constipation, laxative use, and colon cancer among middle-aged adults. Epidemiology. 1998, 9 (4): 385-391. 10.1097/00001648-199807000-00007.


    Google Scholar 

  • 40.

    Jain M, Cook GM, Davis FG, Grace MG, Howe GR, Miller AB: A case-control study of diet and colorectal cancer. Int J Cancer. 1980, 26 (6): 757-768. 10.1002/ijc.2910260609.


    Google Scholar 

  • 41.

    Jensen J, Kewenter J, Swedenborg J: The correlation of symptoms, occult blood tests, and neoplasms in patients referred for double-contrast barium enema. Scand J Gastroenterol. 1993, 28 (10): 911-914. 10.3109/00365529309103134.


    Google Scholar 

  • 42.

    Kassa E: Colonoscopy in the investigation of colonic diseases. East Afr Med J. 1996, 73 (11): 741-745.


    Google Scholar 

  • 43.

    Kojima M, Wakai K, Tokudome S, Tamakoshi K, Toyoshima H, Watanabe Y, Hayakawa N, Suzuki K, Hashimoto S, Ito Y, Tamakoshi A: Bowel movement frequency and risk of colorectal cancer in a large cohort study of Japanese men and women. Br J Cancer. 2004, 90 (7): 1397-1401. 10.1038/sj.bjc.6601735.

    PubMed Central 

    Google Scholar 

  • 44.

    Kune GA, Kune S, Field B, Watson LF: The role of chronic constipation, diarrhea, and laxative use in the etiology of large-bowel cancer. Data from the Melbourne Colorectal Cancer Study. Dis Colon Rectum. 1988, 31 (7): 507-512. 10.1007/BF02553722.


    Google Scholar 

  • 45.

    Lee JF-Y, Ng SS-M, Yiu RY-C, Leung K-L, Lau JW-Y: Colonoscopy in adult patients: A review of tis indications and its yield in detecting colorectal neoplasia. Annals of the College of Surgeons (Hong Kong). 2002, 6: 48-52. 10.1046/j.1442-2034.2002.00130.x.


    Google Scholar 

  • 46.

    Leis VM, Hughes ML, Williams CB, Nuemaster TD, Ludwig DJ, Fontenelle LJ: Risk factors predictive of positive finding at colonoscopy. Curr Surg. 2001, 58: 227-229. 10.1016/S0149-7944(00)00453-0.


    Google Scholar 

  • 47.

    Leung WK, Ho KY, Kim W-h, Lau JYW, Ong E, Hilmi I, Kullavanijaya P, Wang C-y, Li C-j, Fujita R, Abdullah M, Tandon R, Sung JJY: Colorectal neoplasia in Asia: a multicenter colonoscopy survey in symptomatic patients. Gastrointest Endosc. 2006, 64 (5): 751-759. 10.1016/j.gie.2006.06.082.


    Google Scholar 

  • 48.

    Mant A, Bokey EL, Chapuis PH, Killingback M, Hughes W, Koorey SG, Cook I, Goulston KJ, Dent OF: Rectal bleeding. Do other symptoms aid in diagnosis?. Dis Colon Rectum. 1989, 32 (3): 191-196. 10.1007/BF02554525.


    Google Scholar 

  • 49.

    Metcalf JV, Smith J, Jones R, Record CO: Incidence and causes of rectal bleeding in general practice as detected by colonoscopy. Br J Gen Pract. 1996, 46 (404): 161-164.

    PubMed Central 

    Google Scholar 

  • 50.

    Morini S, Hassan C, Meucci G, Toldi A, Zullo A, Minoli G: Diagnostic yield of open access colonoscopy according to appropriateness. Gastrointest Endosc. 2001, 54 (2): 175-179. 10.1067/mge.2001.116565.


    Google Scholar 

  • 51.

    Nakama H, Zhang B, Fattah A, Kamijo N, Fukazawa K: Relationships between a sign of rectal bleeding and the results of an immunochemical occult blood test, and colorectal cancer. Eur J Cancer Prev. 2000, 9 (5): 325-328. 10.1097/00008469-200010000-00006.


    Google Scholar 

  • 52.

    Nakamura GJ, Schneiderman LJ, Klauber MR: Colorectal cancer and bowel habits. Cancer. 1984, 54 (7): 1475-1477. 10.1002/1097-0142(19841001)54:7<1475::AID-CNCR2820540743>3.0.CO;2-M.


    Google Scholar 

  • 53.

    Nascimbeni R, Donato F, Ghirardi M, Mariani P, Villanacci V, Salerni B: Constipation, anthranoid laxatives, melanosis coli, and colon cancer: a risk assessment using aberrant crypt foci. Cancer Epidemiol Biomarkers Prev. 2002, 11 (8): 753-757.


    Google Scholar 

  • 54.

    Neugut AI, Garbowski GC, Waye JD, Forde KA, Treat MR, Tsai JL, Lee WC: Diagnostic yield of colorectal neoplasia with colonoscopy for abdominal pain, change in bowel habits, and rectal bleeding. Am J Gastroenterol. 1993, 88 (8): 1179-1183.


    Google Scholar 

  • 55.

    Panzuto F, Chiriatti A, Bevilacqua S, Giovannetti P, Russo G, Impinna S, Pistilli F, Capurso G, Annibale B, Delle Fave G: Symptom-based approach to colorectal cancer: survey of primary care physicians in Italy. Dig Liver Dis. 2003, 35 (12): 869-875. 10.1016/j.dld.2003.07.005.


    Google Scholar 

  • 56.

    Park Y, Freedman AN, Gail MH, Pee D, Hollenbeck A, Schatzkin A, Pfeiffer RM: Validation of a colorectal cancer risk prediction model among white patients age 50 years and older. J Clin Oncol. 2009, 27 (5): 694-698. 10.1200/JCO.2008.17.4813.


    Google Scholar 

  • 57.

    Pernu J: An epidemiological study of the digestive organs and respiratory system. Annales Medicinae Internae Fenniae Supplementum. 1960, 49 (supp 33): 1-117.


    Google Scholar 

  • 58.

    Roberts MC, Millikan RC, Galanko JA, Martin C, Sandler RS: Constipation, laxative use, and colon cancer in a North Carolina population. Am J Gastroenterol. 2003, 98 (4): 857-864. 10.1111/j.1572-0241.2003.07386.x.


    Google Scholar 

  • 59.

    Robertson R, Campbell C, Weller DP, Elton R, Mant D, Primrose J, Nugent K, Macleod U, Sharma R: Predicting colorectal cancer risk in patients with rectal bleeding. Br J Gen Pract. 2006, 56 (531): 763-767.

    PubMed Central 

    Google Scholar 

  • 60.

    Sardinha TC, Nogueras JJ, Ehrenpreis ED, Zeitman D, Estevez V, Weiss EG, Wexner SD: Colonoscopy in octogenarians: a review of 428 cases. Int J Colorectal Dis. 1999, 14 (3): 172-176. 10.1007/s003840050205.


    Google Scholar 

  • 61.

    Schoepfer A, Marbet UA: Colonoscopic findings of symptomatic patients aged 50 to 80 years suggest that work-up of tumour suspicious symptoms hardly reduces cancer-induced mortality. Swiss Med Wkly. 2005, 135 (45-46): 679-683.


    Google Scholar 

  • 62.

    Selvachandran SN, Hodder RJ, Ballal MS, Jones P, Cade D: Prediction of colorectal cancer by a patient consultation questionnaire and scoring system: a prospective study. Lancet. 2002, 360 (9329): 278-283. 10.1016/S0140-6736(02)09549-1.


    Google Scholar 

  • 63.

    Steine S, Stordahl A, Laerum F, Laerum E: Referrals for double-contrast barium examination. Factors influencing the probability of finding polyps or cancer. Scand J Gastroenterol. 1994, 29 (3): 260-264. 10.3109/00365529409090474.


    Google Scholar 

  • 64.

    Tan YM, Rosmawati M, Ranjeev P, Goh KL: Predictive factors by multivariate analysis for colorectal cancer in Malaysian patients undergoing colonoscopy. J Gastroenterol Hepatol. 2002, 17 (3): 281-284. 10.1046/j.1440-1746.2002.02694.x.


    Google Scholar 

  • 65.

    Tate JJ, Royle GT: Open access colonoscopy for suspected colonic neoplasia. Gut. 1988, 29 (10): 1322-1325. 10.1136/gut.29.10.1322.

    PubMed Central 

    Google Scholar 

  • 66.

    Thompson MR, Perera R, Senapati A, Dodds S: Predictive value of common symptom combinations in diagnosing colorectal cancer. Br J Surg. 2007, 94 (10): 1260-1265. 10.1002/bjs.5826.


    Google Scholar 

  • 67.

    Vobecky J, Caro J, Devroede G: A case-control study of risk factors for large bowel carcinoma. Cancer. 1983, 51 (10): 1958-1963. 10.1002/1097-0142(19830515)51:10<1958::AID-CNCR2820511036>3.0.CO;2-W.


    Google Scholar 

  • 68.

    Watanabe T, Nakaya N, Kurashima K, Kuriyama S, Tsubono Y, Tsuji I: Constipation, laxative use and risk of colorectal cancer: The Miyagi Cohort Study. Eur J Cancer. 2004, 40 (14): 2109-2115. 10.1016/j.ejca.2004.06.014.


    Google Scholar 

  • 69.

    Wauters H, Van Casteren V, Buntinx F: Rectal bleeding and colorectal cancer in general practice: diagnostic study. BMJ. 2000, 321 (7267): 998-999. 10.1136/bmj.321.7267.998.

    PubMed Central 

    Google Scholar 

  • 70.

    Wynder EL, Kajitani T, Ishikawa S, Dodo H, Takano A: Environmental factors of cancer of the colon and rectum. II. Japanese epidemiological data. Cancer. 1969, 23 (5): 1210-1220. 10.1002/1097-0142(196905)23:5<1210::AID-CNCR2820230530>3.0.CO;2-M.


    Google Scholar 

  • 71.

    Wynder EL, Shigematsu T: Environmental factors of cancer of the colon and rectum. Cancer. 1967, 20 (9): 1520-1561. 10.1002/1097-0142(196709)20:9<1520::AID-CNCR2820200920>3.0.CO;2-3.


    Google Scholar 

  • 72.

    Zbar AP, Pignatelli M, Sherman D, Toomey P, Kmiot WA: An analysis of site-specific attributable pathologies for colorectal symptoms: diagnostic yield of colonoscopy. Colorectal Dis. 1988, 1:

    Google Scholar 

  • 73.

    Zerey M, Paton BL, Khan PD, Lincourt AE, Kercher KW, Greene FL, Heniford BT: Colonoscopy in the very elderly: a review of 157 cases. Surg Endosc. 2007, 21 (10): 1806-1809. 10.1007/s00464-007-9269-x.


    Google Scholar 

  • 74.

    Deeks JJ, Altman DG: Diagnostic tests 4: likelihood ratios. BMJ. 2004, 329 (7458): 168-169. 10.1136/bmj.329.7458.168.

    PubMed Central 

    Google Scholar 

  • 75.

    Soares-Weiser K, Burch J, St John J, Smith S, Westwood M, Kleijnen J: Diagnostic accuracy and cost-effectiveness of faecal occult blood tests used in screening for colorectal cancer: A systematic review. 2007, York: Centre for Reviews and Dissemination

    Google Scholar 

  • 76.

    Ford AC, Veldhuyzen van Zanten SJ, Rodgers CC, Talley NJ, Vakil NB, Moayyedi P, Veldhuyzen van Zanten SJO: Diagnostic utility of alarm features for colorectal cancer: systematic review and meta-analysis. Gut. 2008, 57 (11): 1545-1553. 10.1136/gut.2008.159723.


    Google Scholar 

  • 77.

    Jellema P, van der Windt DAWM, Bruinvels DJ, Mallen CD, van Weyenberg SJB, Mulder CJ, de Vet HCW: Value of symptoms and additional diagnostic tests for colorectal cancer in primary care: systematic review and meta-analysis. BMJ. 2010, 340: c1269-10.1136/bmj.c1269.

    PubMed Central 

    Google Scholar 

  • 78.

    Olde Bekkink M, McCowan C, Falk GA, Teljeur C, Van de Laar FA, Fahey T: Diagnostic accuracy systematic review of rectal bleeding in combination with other symptoms, signs and tests in relation to colorectal cancer. Br J Cancer. 2010, 102 (1): 48-58. 10.1038/sj.bjc.6605426.


    Google Scholar 

  • 79.

    Shapley M, Mansell G, Jordan JL, Jordan KP: Positive predictive values of >= 5% in primary care for cancer: systematic review. Br J Gen Pract. 2010, 60 (578): e366-377. 10.3399/bjgp10X515412.

    PubMed Central 

    Google Scholar 

  • 80.

    Buck A, Gart J: Comparison of a screening test and a reference test in epidemiologic studies. I. Indices of agreement and their relation to prevalence. American Journal of Epidemiology. 1966, 83 (3): 586-592.


    Google Scholar 

  • 81.

    Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig LM, Lijmer JG, Moher D, Rennie D, de Vet HCW: Towards complete and accurate reporting of studies of diagnostic accuracy: the STARD initiative. BMJ. 2003, 326 (7379): 41-44. 10.1136/bmj.326.7379.41.

    PubMed Central 

    Google Scholar 

  • 82.

    Adelstein B-A, Irwig L, Macaskill P, Katelaris PH, Jones DB, Bokey L: A self administered reliable questionnaire to assess lower bowel symptoms. BMC Gastroenterol. 2008, 8: 8-10.1186/1471-230X-8-8.

    PubMed Central 

    Google Scholar 

  • How to evaluate stools with Bristol stool chart

    Researchers at the Bristol Royal Infirmary—a hospital in Bristol, England—developed a visual guide for stools. It is called the Bristol Stool Form Scale, or BSF scale for short. It helps skittish patients and doctors to distinguish normal stools from abnormal without getting embarrassed over personal details.


    The normality of ones’ stools is determined by
    comparing them to the Bristol Stool Form scale, or the BSF scale for
    short. The ‘Bristol’ in the BSF refers to the Bristol Royal Infirmary —
    a hospital in Bristol, England — from where this scale originated.

    It is a self-diagnostic chart designed to help skittish
    patients discuss this delicate subject with their doctors without
    getting embarrassed. This is, essentially, what the Brits call getting
    the “royal treatment…”

    You just look at the picture, point to what
    approximates the content of your toilet bowl, and your doctor tells you
    whether your type is good or bad…

    Type 4 and 5 are considered “normal”. I provide a
    detailed explanation, and what to do to get your own type in order on
    this page.

    Also, if you are a parent or a guardian of a young
    child, use this chart to fix minor problems well before they become a
    major headache for you and a source of life-long trouble for your child.

    Good luck!

    Bristol stool form scale

    You just look at a simple chart,
    point to what approximates the content of your toilet bowl, and your
    doctor (or this page) tells you whether the form is right or wrong.

    Source: Wikipedia; licensed under the Creative Commons [link]

    Type 1: Separate hard lumps,
    like nuts

    Typical for acute dysbacteriosis. These stools lack a
    normal amorphous quality, because bacteria are missing and there is
    nothing to retain water. The lumps are hard and abrasive, the typical
    diameter ranges from 1 to 2 cm (0.4–0.8”), and they‘re painful to pass,
    because the lumps are hard and scratchy. There is a high likelihood of
    anorectal bleeding from mechanical laceration of the anal canal. Typical
    for post-antibiotic treatments and for people attempting fiber-free
    (low-carb) diets. Flatulence isn‘t likely, because fermentation of fiber
    isn‘t taking place.

    Type 2: Sausage-like but

    Represents a combination of Type 1 stools impacted into a
    single mass and lumped together by fiber components and some bacteria.
    Typical for organic constipation. The diameter is 3 to 4 cm (1.2–1.6”).
    This type is the most destructive by far because its size is near or
    exceeds the maximum opening of the anal canal‘s aperture (3.5 cm). It‘s
    bound to cause extreme straining during elimination, and most likely to
    cause anal canal laceration, hemorrhoidal prolapse, or diverticulosis.
    To attain this form, the stools must be in the colon for at least
    several weeks instead of the normal 72 hours. Anorectal pain,
    hemorrhoidal disease, anal fissures, withholding or delaying of
    defecation, and a history of chronic constipation are the most likely
    causes. Minor flatulence is probable. A person experiencing these stools
    is most likely to suffer from irritable bowel syndrome because of
    continuous pressure of large stools on the intestinal walls. The
    possibility of obstruction of the small intestine is high, because the
    large intestine is filled to capacity with stools. Adding supplemental
    fiber to expel these stools is dangerous, because the expanded fiber has
    no place to go, and may cause hernia, obstruction, or perforation of the
    small and large intestine alike.

    Type 3: Like a sausage but
    with cracks in the surface

    This form has all of the characteristics
    of Type 2 stools, but the transit time is faster, between one and two
    weeks. Typical for latent constipation. The diameter is 2 to 3.5 cm
    (0.8–1.4”). Irritable bowel syndrome is likely. Flatulence is minor,
    because of dysbacteriosis. The fact that it hasn‘t become as enlarged as
    Type 2 suggests that the defecations are regular. Straining is required.
    All of the adverse effects typical for Type 2 stools are likely for type
    3, especially the rapid deterioration of hemorrhoidal disease.

    » Type 4: Like a sausage or snake, smooth and soft

    This form is normal for someone defecating
    once daily. The diameter is 1 to 2 cm (0.4–0.8”). The larger diameter
    suggests a longer transit time or a large amount of dietary fiber in the

    » Type 5: Soft blobs with clear-cut edges

    I consider this form ideal. It is typical for a
    person who has stools twice or three times daily, after major meals. The
    diameter is 1 to 1.5 cm (0.4–0.6”).

    Type 6:
    Fluffy pieces with ragged edges, a mushy stool

    This form is close to
    the margins of comfort in several respects. First, it may be difficult
    to control the urge, especially when you don‘t have immediate access to
    a bathroom. Second, it is a rather messy affair to manage with toilet
    paper alone, unless you have access to a flexible shower or bidet.
    Otherwise, I consider it borderline normal. These kind of stools may
    suggest a slightly hyperactive colon (fast motility), excess dietary
    potassium, or sudden dehydration or spike in blood pressure related to
    stress (both cause the rapid release of water and potassium from blood
    plasma into the intestinal cavity). It can also indicate a
    hypersensitive personality prone to stress, too many spices, drinking
    water with a high mineral content, or the use of osmotic (mineral salts)

    Type 7: Watery, no solid

    This, of course, is diarrhea, a subject outside the scope of this
    chapter with just one important and notable exception—so-called
    paradoxical diarrhea. It‘s typical for people (especially young children
    and infirm or convalescing adults) affected by fecal impaction—a
    condition that follows or accompanies type 1 stools. During paradoxical
    diarrhea the liquid contents of the small intestine (up to 1.5–2
    liters/quarts daily) have no place to go but down, because the large
    intestine is stuffed with impacted stools throughout its entire length.
    Some water gets absorbed, the rest accumulates in the rectum. The reason
    this type of diarrhea is called paradoxical is not because its nature
    isn‘t known or understood, but because being severely constipated and
    experiencing diarrhea all at once, is, indeed, a paradoxical situation.
    Unfortunately, it‘s all too common.

    Interestingly, the interpretations and
    explanations of the BSF scale that accompany the original chart differ from my analysis. To
    this I can only say: thanks for great pictures, but, no thanks
    for the rest…

    How to interpret BSF scale

    To avoid referencing
    non-descriptive numbers, I use the following definitions: types 1, 2 and
    3 = hard or impacted stools. Type 4 and 5 = normal or optimal. Type 6 =
    loose stool, subnormal, or suboptimal, and type 7 = diarrhea.

    In such cases as acute hemorrhoidal disease, anal
    fissure, or the inability to attain unassisted stools, loose stools (type 6)
    are acceptable. It‘s a messy experience, but which would you rather have
    — a bucketful of blood, pain, and a wound that won‘t heal, or a little
    lukewarm douche afterwards?

    To restore and maintain normal stools (from type 4 to
    6), the colon and rectum must first be free from hard stools (from type
    1 to 3). In our case, the opposite of “hard” isn‘t “soft,” but difficult
    (not easy) or irregular.

    As you can see from the illustration (and, perhaps,
    already know firsthand) “hard” stools can be “small,” “regular,” and
    “large.” Equally important, a “small” stool for one person can be
    “large” for another, because the perception of size isn‘t determined by
    a caliper, but by the aperture of one‘s anal canal. If the anal canal is
    constrained by enlarged internal hemorrhoids, even “small” stools, such
    as type 4, may be “difficult” to pass. Don‘t fall
    into this trap. The rule is: If stools are hard as in difficult, or not easy, or irregular, they are HARD,

    Unless your stools are type 4 to 6 (normal), they are
    impacted. Impacted stools can be small, large, hard, soft, dry, moist—it
    doesn‘t matter. What “impacted” means is that they had a chance to pile
    up and compress in the large intestine. Despite all of the nonsense
    you‘ve been hearing about “formed” stools, if yours are “formed,” they
    are impacted.

    If we didn‘t have the Bristol Stool Form scale
    illustration in front of us, and you asked me what are normal stools, I
    would answer: normal stools are
    not noticeable during defecation!

    Again, for someone with an intact anal canal, this may
    consist of formed stools as in type 4. For someone with hemorrhoidal
    disease, this may only be loose stools as in type 5 or 6. In other
    words, the normality differs from person to person, depending on the
    degree of prior damage. It‘s pretty much similar to defining pornography
    in the context of free speech: I can‘t tell you what pornography is, but
    I can tell when I see it. Similarly, I can‘t tell you what normal stools
    are, but you can tell when you don‘t have them.

    As you can see from the BSF scale, normal stools don‘t
    have to be round. After all, your anal canal isn‘t really round (when
    shut, it‘s actually flat), particularly if you already have enlarged
    internal hemorrhoids. So a flat shape is okay. In fact, when stools are
    already round as in type 4, it means you already have a slight degree of
    impaction. Otherwise their shape would be flattened up while passing
    through the anal canal.

    Flat stools scare doctors a great deal because type 2,
    3 and, to a lesser extent, type 4 may indicate the presence of a colorectal
    tumor. But that’s because few doctors have ever observed normal (type 5)
    stools themselves.

    Here is what’s actually happening: think of the colon
    as a round mold. Then, it‘s easy to imagine why a tumor may change
    impacted stools from the round shape to a flat shape. This rare
    occurrence doesn‘t apply to type 5 stools, because their shape is formed
    primarily by the shape of the anal canal, not the colon‘s “mold.”

    To rule out a tumor scare — don‘t panic! Withhold your
    stools for few days to give them the opportunity to get molded. Observe
    their shape, and calm yourself down and your doctor.

    Let’s summarize:

    • Abnormal stools are any stools that require straining
      and/or you feel pressure from stools passing through the anal canal.
    • Abnormal stools may be small or large size-wise,
      depending on fiber consumption, and frequency of defecation.
    • Normal stools can be loose or slightly formed (Such as
      BSF type 5).
    • Normal stools (between BSF type 4 and 6) aren‘t perfectly round.
    • Normal stools for one person may be abnormal for
      another. The degree of normality is determined by the anatomy of the
      anal canal.
    • Normal stools require zero effort and zero straining
      for elimination.
    • Normal stools pass through the anal canal without any
      perception of pressure.

    Of course, once you have damage to the anal canal,
    achieving absolute “normality” may be hard. So you may have to accept a
    small degree of “abnormality” such as type 6 stools. This is no
    different from accepting gray hair, wrinkles, dental implants, and so

    You may also have to live with the fact that after a
    certain degree of prior damage, caused by fiber, you won‘t be able to
    attain “unassisted” defecation and “normal” stools because of
    irreversible nerve damage, stretching of the large intestine,
    significantly enlarged hemorrhoids, and similar factors. I‘ll teach you
    how to overcome this problem as well without fiber and laxatives.

    In fact, if I didn‘t know how to attain this seemingly
    impossible goal, I wouldn‘t be touching this subject or this site. I
    only got into this game when I was assured of a winning hand.

    Reader’s testimonial “Although I have been using your products for only
    two days, I can say with no hesitation that your
    products work. I am amazed they are working so
    Thank you again for creating a truly wonderful
    product. I hope that you are able to spread the
    truth far and wide and that hundreds of thousands of
    people achieve better health because of your
    outstanding work. One person truly can make a
    difference.” L.C., USA (via e-mail)

    What is latent

    A generation or so ago the term “costivity” was broadly
    used to describe hard stools and straining, while the term
    constipation” was used to describe “irregularity,”
    meaning “a failure to move the bowels daily.”

    Since then, the terms costivity and constipation have blended into one, while the “failure to move the bowels for
    three consecutive days
    ” has become the ‘official’ definition of clinical constipation.

    On the other hand, painful and bloody stools within
    these three
    days has become a mere irregularity, or a doctor-speak for “don’t
    bore me with your problems until the fourth day

    In practical terms, this means that the definition of
    “constipation” has become too vague and unspecific — a situation akin to
    doctors not knowing the location of your heart or liver. Indeed, how can
    you get proper treatment, when constipation for you means “pain while
    moving the bowels,”, while it may mean the “failure to move the bowels
    for three consecutive days” for your doctor!

    For this and other practical reasons I reclassified constipation (see Fiber Menace, p.p. 97-128 for more details) into three distinct stages: functional (reversible),
    (hidden), and organic (irreversible):

    • Functional constipation. This condition commonly follows a stressful event, surgery, colonoscopy, diarrhea, temporary
      incapacity, food poisoning,
      treatment with antibiotics, the side effects of new medication — the circumstances that damage
      intestinal flora, interfere with intestinal peristalsis, or both. A person
      becomes irregular, stools correspond to the BSF scale type 1 to 3, and
      straining is required to
      move the bowels. The person resorts to fiber or laxatives for help.
    • Latent constipation. If the intestinal flora,
      stools, and peristalsis aren’t properly
      restored following adverse event(s), functional constipation
      eventually turns into
      the latent form (i.e. hidden), because
      fiber‘s or the laxative’s effects on stools create the impression of normality
      and regularity.
      The stools become larger, heavier, and harder, usually the BSF type 3,  straining more intense,
      but for as long as you keep moving your bowels every so often, and without
      too much pain, there is still an impression of regularity. This is, by
      far, the most dangerous form of constipation because of what happens
    • Organic constipation. As time goes by,
      large and hard stools — between type 2 and 3 — keep enlarging internal
      hemorrhoids and stretching out the colon. This, in turn, reduces
      the diameter of the anal canal even more, causes near complete anorectal nerve damage,
      and slows down or cancels out completely the propulsion of stools
      alongside the colon (motility). At
      this juncture, the person no longer senses a defecation urge, and
      becomes dependent on intense straining and/or laxatives to complete a bowel movement. If you
      don’t use ‘hard’ laxatives, you fail to move the bowels even with a good
      helping of fiber. That is, in fact, what most people mean nowadays when
      they say: “I have been diagnosed with constipation.”

    So, as you can see, you can indeed use fiber to coax
    your bowels into regularity for a good while, but at the expense of
    enlarged stools. At some point in that ‘while,’ you’ll also end up with
    damaged bowels, and a life-long dependence on more and more fiber, and
    ‘hard’ laxatives

    How long that ‘while’ may last depends on how early you
    get started with this crazy therapy. If you are in your teens today,
    you’ll pay the price in your early forties, if you are in your early
    forties, damnation will come by your early fifties. If you are a woman,
    things will go downhill even faster for reasons explained on this page: Why Women Get Constipated More
    Often Than Men?

    How to overcome constipation by “normalizing” stools

    Constipation rarely happens out of the blue in
    otherwise healthy adults. It is
    usually preceded by decades of semi-regular stools that are either
    too large, or too hard, or both. These abnormal stools cause gradual
    nerve damage and enlargement of the colon, rectum, and
    hemorrhoidal pads until one day the bowels refuse to move as was meant by
    nature — once or twice daily, usually after a meal, and with zero effort
    or notice. Therefore, it’s best to recognize and eliminate abnormal
    stools long before they
    bite you in the butt, literally and figuratively.

    To attain small stools and effortless bowel movements
    immediately— use the  Hydro-CM program. 
    The duration depends on the degree of acquired colorectal damage. The
    goal is to eliminate straining, reduce pressure on internal hemorrhoids,
    and restore anorectal sensitivity.

    For a comprehensive, life-long recovery, start from this
    section: No Downside,
    Just Upside-down

    You may also find relief by reviewing the answers to the following questions:

    Of course, you may opt to do
    nothing, continue to strain and use fiber and/or laxatives, and we’ll
    meet again several years from now, except the next time around it will
    be even more difficult, involved, and expensive to return to normality.
    That’s, unfortunately, the nature of the beast — as the years pass,
    colorectal disorders related to abnormal stools become more severe, and
    the damage— irreversible!

    but true — the content of your toilet bowl predicts your future with
    more certainty than a crystal ball. With that in mind, read up, look
    down, and stay well!

    Constipation – seriously about a delicate problem

    _Title Constipation – seriously about a delicate problem

    When should you talk about constipation?
    Constipation is a clinical symptom characterized by:

    • a decrease in the frequency of bowel movements less than 3 times a week
    • a decrease in the amount (mass) of feces excreted
    • a change in its consistency (hard) and shape (fragmented, or “Sheep”, tape, “sausage-like” with a bumpy surface)
    • the presence of dissatisfaction with the act of defecation (feeling of incomplete emptying of the intestines).

    In order to diagnose constipation, it is not at all necessary that the patient has all the indicated symptoms at once, it is enough to have one or more. In some cases, even a change in the frequency and rhythm of defecation, which is habitual for a given person, should be considered, if not as constipation, then at least as the appearance of a tendency to it.

    Is constipation a serious medical problem?

    Definitely – “yes”! Constipation is a clinical syndrome that can occur in both children, including infants, and adults.For various reasons, accurate statistics on the prevalence of constipation among the world’s population are not available, although many experts note a significant increase in the number of people suffering from constipation. According to some reports, this symptom occurs in almost 10 million French people, 30% of the German population. It should be assumed that in other countries the prevalence of constipation is at a similar level.

    Such a high percentage of their occurrence is not accidental, this is facilitated by a sedentary lifestyle, the predominance of refined high-calorie foods in the diet, obesity and other attributes of “civilization”.The elderly and the elderly are five times more likely to suffer from constipation, but some experts believe that these figures are somewhat overestimated, since these populations place high importance on bowel movements and therefore report constipation even when they are not actually present.

    However, a wary attitude towards constipation in the elderly and the elderly cannot be called accidental or erroneous, since this syndrome can be both a “harmless” consequence of a sedentary lifestyle and an irrational diet, reasons that, if desired, can be easily eliminated, and early a symptom of a serious illness, such as a colon tumor.That is why constipation requires serious treatment.

    Promotion of food, chyme and feces along the digestive tract and emptying the intestines
    After swallowing food enters the stomach through the esophagus, where it is stirred for 90-120 minutes, crushed and processed with digestive juice, turning into chyme (see dyspepsia). In the small intestine, chyme undergoes further digestion, followed by absorption of the main classes of nutrients (proteins, fats, carbohydrates), vitamins, and microelements.Undigested, and therefore not absorbed, liquid food residues (1-2 liters), on average, 4-5 hours after eating, reach the large intestine, a segment of the intestine in which feces are formed.

    If in the initial (proximal) part of it there is a suction of excess liquid and basic salts, then in the final (distal) part – the accumulation and formation of feces. The time for the movement of feces from the proximal to the distal part of the large intestine is on average 3-4 hours. It is important to note that the sigmoid segment of the large intestine at the place of transition to the rectum has a bend at an angle of 90 degrees., overcoming which fecal masses enter the anal canal (ampulla). When a person flexes the hip (squats), this angle is straightened, which makes it easier for feces to enter the rectum. As fecal masses accumulate in the anal canal, it stretches, followed by spontaneous (reflex) contraction. On the way of feces there are two muscle pulp (sphincters) – internal, involuntarily relaxing when the pressure in the rectal ampulla rises, and external, controlled by a person.When suitable conditions for defecation appear, the patient relaxes the external anal sphincter, strains (increases intra-abdominal pressure) and the bowel is emptied.

    Causes of constipation

    They can be conditionally divided into functional, caused by a violation of the physiological process of regulation of bowel emptying, alimentary, food-induced, medicinal, caused by some drugs and organic, associated with various diseases and pathological conditions of the colon, others organs and systems.

    This allocation is very conditional, since often in each particular person, several factors act as causes of constipation at once.

    Functional constipation

    Most often develops as a result of regular “containment” of the urge to defecate, as a result of which the sensitivity of the nerve endings that react to the stretching of the rectal ampulla decreases. The feces gradually accumulate in the distal segment of the large intestine, and the remaining moisture is absorbed from it (the feces are “dried up”).Chronic stretching of this section of the large intestine reduces its contractility, which aggravates constipation.

    Among the reasons why a person usually restrains the natural urge to defecate, one should name:

    • nervous tension as a result of workload, conflict situations, depression, etc.
    • prolonged violation of the usual daily routine
    • constantly changing work schedule (day – night shifts)
    • frequent business trips
    • lack of habitual conditions for bowel movements, including unsanitary conditions in the toilet, hospital stay
    • late waking up, and therefore constant lack of time in the morning hours

    Functional constipation should also include a disease such as, according to today’s views, it is based on a functional disorder of the motor function of the large intestine, one of the manifestations of which is constipation.

    It is customary to refer to the alimentary factors contributing to the development of constipation:

    • a decrease in the content of plant fibers in the diet, an integral component of rational food, since they are not digested by digestive enzymes, increase the volume of feces and stimulate peristalsis ( contractile activity ) colon, thereby facilitating the process of defecation
    • Increase in the diet of refined ( refined ) products that are completely digested and absorbed ( so-called non-toxin food )
    • Abuse of fatty and protein foods of animal origin ( dairy products, eggs, meat ) with a sharp restriction of vegetable fats ( they are natural stimulators of contraction of the gallbladder, and therefore the delivery of bile into the digestive tract, and bile, as you know, has a laxative effect ktom )
    • Eating fast food
    • Fluid restriction
    • Abuse of caffeinated foods, especially coffee

    The most common causes of organic constipation are:

    • Disruption of normal passage fecal masses in the colon due to narrowing of its lumen and / or pressure from the outside

      • Inflammatory edema or scar tissue that appeared after healing of deep ulcers
      • Tumors or foreign bodies trapped in the intestine
      • Fecal “stones”
      • Volvulus intestines ( intestinal obstruction )
      • Hernias of the white line of the abdomen

    • Disruption of the nervous regulation of the motor function of the colon in diseases of the central and peripheral nervous system ( tumors and traumatic injuries of the spinal brain, multiple sclerosis )
    • Systemic connective tissue diseases ( scleroderma and systemic lupus erythematosus )
    • Metabolic and endocrine disorders

      • Decreased thyroid function ( myxedema )
      • 4 Diabetes mellitus

      • Decreased blood potassium levels ( hypokalemia )
      • Increased blood calcium levels, for example, as a result of excessive parathyroid hormone secretion by the parathyroid glands ( hyperparathyroidism )
      • Uremia ( renal failure


      • 9 Chronic metal poisoning, such as lead
      • Chronic ischemia ( insufficient blood supply ) of the colon

      Constipation can occur both during pregnancy and after delivery .Several factors can contribute to their development at once:

      • Mechanical pressure on the intestines by an enlarged uterus, especially in the presence of a large fetus
      • Changes in hormonal levels
      • Changes in diet and restriction of fluid intake
      • Cracks around the anus and / or narrowing (stenosis) of the anal ring
      • Hemorrhoids

      The last of these factors are more common after delivery, contribute to pain during bowel movements, which causes a reflex spasm of the anal sphincter and a decrease in the motor activity of the rectum, thereby making emptying even more difficult intestines.

      Given the higher incidence of constipation among the elderly and senile age, it is necessary to focus on the most common causes of their development in this contingent.

      Most often constipation in the elderly and the elderly is associated with :

      • dietary errors ( preference for refined products ) and insufficient fluid intake
      • low physical activity and / or prolonged lying due to somatic diseases, traumatic fractures
      • by the influence of drugs used to treat concomitant diseases ( see.below )
      • the usual use of laxatives or enemas for emptying the intestines
      • ischemia of the colon and, as a result, deterioration of metabolic processes in it, a decrease in peristaltic activity

      Medicines that contribute to constipation include:

      • Psychotropic drugs ( antidepressants, antipsychotics used in the treatment of Parkinson’s disease, for example levodopa )
      • Cation-containing drugs :

        • aluminum: antacids, acidic acid stomach )
        • calcium: antacids, multivitamins and nutritional supplements
        • bismuth: alkali or citrate ( are active against Helicobacter pylori – the main cause of duodenal and stomach ulcers )
        • iron: use are used in the treatment of anemia associated with iron deficiency in the body

      • Preparations from various pharmacological groups :

        • calcium channel blockers: first of all, verapamil, as well as diltiazem, nafedipine, etc.
        • other antihypertensive drugs, for example, clonidine, we know as clonidine
        • diuretics ( furosemide, hypothiazide, etc. )
        • cholestyramine (binds bile acids in the intestine, disrupting their absorption – used in the treatment of accompanying stagnation of bile, or cholestatic conditions)
          o non-steroidal anti-inflammatory drugs ( diclofenac, ibuprofen, indomethacin, etc. )
        • narcotic analgesics ( opiates )
        • vinca alkaloids ( cavinton, vinca)
        • belladonna alkaloids ( belladonna ), atropine, platyphylline, metacin and, potentially, other anti-spasm drugs
        • sympathomimetics, for example, bronchial dilating beta-adrenomimetics ( malbutamol and others
        • 89)
          900oblockers ( gangleron, benzohexonium )

      • Laxatives ( despite the seeming paradoxicality – their frequent use contributes to the development of addiction, which at the beginning can be overcome by increasing the dose, and later become the reason for the lack of sensitivity to this class of drugs )

      The main clinical manifestations of constipation

      Depending on gender, age, diet, habits related to bowel movements, people can present a wide variety of complaints of constipation.The most common complaints are:

      • Lack of regular urge to defecate or difficulty in passing through the anus
      • Feces passing less than 3 times a week, more often in small amounts
      • Discharge after a long stay in the toilet, hard, more often fragmented , or “sheep”, tape, “sausage-like” with a bumpy surface of feces
      • Cramping migratory pain in the abdomen, bloating (flatulence), poor gas discharge, a feeling of incomplete emptying of the intestines ( most often the whole “bouquet” is found in irritable intestines )
      • Nausea, vomiting, abdominal pain, lack of bowel movement and gas discharge !!! ( serious symptoms that require urgent medical advice, since they may be a manifestation of intestinal obstruction )
      • Abdominal heaviness, lack of appetite
      • Tongue obstructed, bad breath when breathing, bad taste in the mouth
      • Sometimes occurs so-called constipation diarrhea, when, with a prolonged delay in bowel movement, the feces are liquefied by mucus formed as a result of irritation of the intestinal wall
      • Pain in the head, muscles, decreased ability to work, general nervousness, depressed mood, sleep disturbance
      • Prolonged constipation can cause changes properties of the skin, they lose elasticity, becoming flabby, acquire a pale yellow tint.

      What to do if constipation appears recently?

      First of all, don’t panic! If you have reason to believe that they are caused by any disease, then you should not, like an ostrich, “hide your head in the sand” without noticing the problem that has arisen. You should discuss your assumptions with a specialist. However, for the most part, constipation, especially in young and mature people, is functional or alimentary ( see above ).

      In such cases you should try to increase your intake :

      • vegetable dietary fiber: special, containing bran, bread, or better bran in pure form, vegetables and fruits
      • liquids: at least 6-8 glasses of water , juice, better with pulp (apricot, plum, peach, pumpkin, carrot, etc.)in addition to the liquid consumed with food

      It may be helpful to go to the toilet at the same time, preferably after eating. In no case should you leave going to the toilet at the “last moment”. Eat non-digestible carbohydrates such as lactulose or natural honey.

      You should not habituate yourself to laxatives, especially those containing hay (Senokot) or buckthorn (Rhamnus purshiana), because long-term consumption of them can damage the mucous membrane of the colon and the nerves located in the submucosa, which will further aggravate constipation.

      Regularly engage in physical exercises that improve the motility of the colon, such as bringing the thigh to the chest (stay in this position for at least 10-15 minutes during the day). During exercise, you should take deep breaths in and out.

      When is it necessary to see a doctor?

      • If you have persistent constipation lasting more than 3 weeks, which tends to get worse
      • If you have recently had a significant violation of the process of bowel movement, for example, alternating constipation and diarrhea
      • If, along with constipation, symptoms of another disease occur , which may be accompanied by constipation, for example, difficulty swallowing, vasospasm of the limb vessels when the ambient temperature drops, and therefore poor cold tolerance, etc.manifestations of systemic scleroderma
      • Constipation lasting more than two weeks and accompanied by recurrent abdominal pain ( the possibility of so-called lead colic in chronic poisoning with this metal )
      • One or more alarming symptoms (“red flags” ) !!!

        • Acute sudden onset of constipation
        • Unmotivated weight loss
        • Cramping abdominal pain
        • Discharge of fresh blood from the rectum during bowel movements and / or the appearance of black liquid ( tarry ) stool ( melena )
        • Nausea or vomiting
        • In case of intense pain in the anus during bowel movements
        • Increase in body temperature
        • Change in the caliber of excreted feces (ribbon-shaped or lace-like)

      In what cases may hospitalization be required?

      In the presence of bleeding from the rectum or intraintestinal (fresh or clotted blood in the stool)

    • Pain in the anal opening, especially if there is a fissure in the perianal region
    • Hemorrhoids, especially complicated by bleeding
    • So called fecal obstruction ( more common in infants and very old people )
    • Rectal prolapse
    • Constipation with abdominal pain and recurrent vomiting ( chance of intestinal obstruction requiring surgical treatment )
    • Patient examination, suffering from constipation

      In order for the doctor to better understand the causes of constipation in the patient and choose the most appropriate treatment, he should give clear intelligible answers to the following questions:

      • What is the frequency of bowel movement melts familiar (normal) for yourself?
      • How long has the patient been experiencing difficulty in emptying the bowels?
      • When was the last time he had a chair ( how many days ago )?
      • How well does the patient pass gas?
      • Does the patient have anal or abdominal pain?
      • Is the pain associated with the process of bowel movement, if it is, how does it intensify, weaken, disappear?
      • Is the abdominal pain localized (in the same place) or migrating?
      • What are the properties of this pain ( pressing, stabbing, cramping, etc.)p. )?
      • Did the patient take any medications, if yes, what and how much did they affect constipation and other symptoms?
      • Has the patient previously used laxatives and / or enemas to relieve constipation, if yes, which ones, how often and in what dose?
      • Does the patient feel that he / she cannot do without laxatives or enemas for normal bowel movement?
      • After a bowel movement, does the patient feel better?
      • Along with constipation and pain, are there any other symptoms such as fever, chills?
      • Has the patient’s appetite and body weight changed?
      • Has he previously consulted a doctor about constipation, have any examinations been carried out, if yes, what are they, and what are their results?
      • A woman of childbearing age must answer the question, is she pregnant?
      • Is the patient being monitored by other doctors for other diseases, which ones?
      • What medications does he take regularly, for how long and in what dose?
      • Information on bad habits is important ( smoking – duration, intensity; alcohol – how long, what he prefers, how much per day, week, month; also concerns the consumption of coffee, tea )
      • There were previous operations and about what?
      • Did the patient’s relatives suffer from constipation, bowel cancer?

      After interviewing the patient, the doctor must examine his abdomen, perianal region, other organs and systems (, special attention to the nervous, musculoskeletal systems, skin, thyroid gland ).Depending on what cause of constipation the doctor considers the main one in a particular patient, he draws up an examination plan.

      • Laboratory tests:

        • Clinical study of stool analysis ( coprogram )
        • Clinical blood test
        • Determination of thyroid hormones ( for suspected thyroid pathology )

        900 research:

        • X-ray contrast study of the colon ( irrigoscopy ) – determines the shape, position, size of the colon, its patency, the relief of the mucous membrane, can detect its narrowing as a result of the growth of scar tissue, or compression by the tumor
        • Timing movement of the food bolus – can establish a slowdown in its movement
        • Sigmoscopy ( flexible sigmoidoscope ) – allows you to examine the rectum and sigmoid colon and identify, if present, diseases of these intestinal parts
        • Kolonosko pia – the method allows you to examine the entire large intestine and even a small area of ​​the small intestine and identify, in case of the presence of various diseases,

      And sigmoidoscopy and colonoscopy allow not only to examine the intestinal mucosa, but also to obtain its samples ( biopsies ), which can be subjected to a histological examination, which will significantly increase the accuracy and information content of these diagnostic procedures.

      Systemic vasculitis | Clinical Rheumatology Hospital No. 25

      Systemic vasculitis – a heterogeneous group of disease, based on

      of which there is inflammation of the vascular wall. Moreover, depending on the type of the affected vessel and the nature of the inflammation, there is a special clinical symptomatology with damage to various organs and tissues.

      First of all, vasculitis is divided into primary and secondary .

      Secondary is the vascular lesion that occurs as a
      complication against the background of actively current infectious or oncological diseases.
      In this case, the treatment of these forms of vasculitis is recommended to be carried out by an infectious disease specialist or oncologist until the exacerbation of the main process is relieved. For example, secondary vasculitis often occurs against the background of exacerbation of viral hepatitis, which
      can regress against the background of antiviral therapy conducted by an infectious disease specialist.If successful treatment of the underlying disease did not affect the manifestations of vasculitis, then it is necessary to contact a rheumatologist for further examination.

      Primary vascular damage that occurs as an independent process is called primary. Moreover, in cases where there is a variant of an isolated lesion of the skin (hemorrhagic rash, spots, ulcers, etc.) in the absence of any other signs of inflammation, it is necessary to initially contact a dermatologist who will give all the necessary recommendations and, if necessary, will refer you to other specialists for examination.

      In all other cases of manifestation of systemic vasculitis, observation by a rheumatologist is necessary.

      The etiology of systemic vasculitis is currently not clear, however, the putative risk factors are, first of all, infections (viral, bacterial, etc.), occupational hazards. Most vasculitis has a genetic predisposition.

      Depending on the caliber of the affected vessel, vasculitis is divided into three groups:

      1.Vasculitis with predominantly small-caliber lesions (capillaries, arterioles, venules): granulomatous polyangiitis
      (Wegener’s granulomatosis), eosinophilic granulomatous polyangiitis (Churge-Strauss syndrome), microscopic polyangiitis, hypersensitivity vasculitis, purpura Schoenogulineum’s disease in rheumatic diseases (SLE, RA, SJS, Sjogren’s disease), cutaneous leukocytoclastic vasculitis.

      2. Vasculitis with predominantly medium-sized lesions: Kawasaki disease, polyarteritis nodosa.

      3. Vasculitis with a predominant lesion of large-caliber vessels: giant cell arteritis (Horton’s disease), Takayasu’s arteritis (nonspecific aortoarteritis, aortic arch syndrome).

      Accordingly, depending on the caliber of the affected vessels, their localization and the type of lesion, a certain clinical picture appears.

      In this case, damage to organs and systems can be accompanied by various symptoms:

      – lungs (cough, shortness of breath, hemoptysis, episodes of suffocation),

      – kidneys (edema, increased blood pressure),

      – skin (rashes, ulcers, whitening and blue discoloration of fingers, ulcers in the genital area, gangrene),

      – mucous membranes (mouth ulcers, rashes)

      – musculoskeletal system (pain and swelling of joints, muscle pain),

      – eyes (redness, pain and cramps in the eyes, loss of vision),

      – ENT organs (discharge from the nose and ears, hearing loss and smell, nosebleeds, hoarseness, deformity of the nasal dorsum),

      – nervous system (convulsions, headaches and dizziness, epileptic seizures, strokes, changes in sensitivity, impaired motor function),

      – gastrointestinal tract (abdominal pain, diarrhea, blood in the stool),

      – cardiovascular system (chest pain, interruptions in the work of the heart, increased blood pressure, lack of pulse in the arms or legs), etc.d.

      Fever, weight loss, general weakness are also common. Sometimes the diagnosis of systemic vasculitis takes a long time, since the clinical manifestations can slowly develop and be erased.

      In a laboratory study, an acceleration of ESR, an increase in C-reactive protein, fibrinogen is often revealed, leukocytosis is possible. According to blood and urine tests, kidney damage can be detected (more often an increase in protein, erythrocytes and casts in the urine; an increase in serum creatinine and urea, a decrease in glomerular filtration).

      An immunological study of blood in some vasculitis (granulomatous polyangiitis, eosinophilic granulomatous polyangiitis, microscopic polyangiitis) reveals antineutrophilic cytoplasmic antibodies (ANCA), which significantly helps in clarifying the diagnosis.

      Instrumental examination methods (X-ray, ultrasound, echocardiography, etc.) are also important.

      To confirm the diagnosis, in most cases (if feasible), a biopsy of the affected organ or tissue is performed, followed by histological and immunohistochemical studies.

      For the treatment of systemic vasculitis,
      glucocorticosteroids and cytostatics are most often used. At the same time, to achieve remission, courses of “classical” pulse therapy (3 intravenous infusions of prednisolone 1000 mg and one infusion of 1000 mg cyclophosphamide), plasmapheresis sessions, and intravenous immunoglobulin infusions are carried out. In some cases, genetically engineered biological drugs are used, which are prescribed when standard treatment is ineffective.

      Consultation with a rheumatologist is mandatory for the diagnosis of systemic vasculitis.In this case, self-medication can lead to the progression of the disease and serious life-threatening complications.

      You can consult a rheumatologist to clarify the diagnosis and determine further management tactics at our Clinical Rheumatological Hospital No. 25.

      Details about the work of a rheumatologist and the procedure for applying can be found on the website.

      gaz.wiki – gaz.wiki


      • Main page


      • Deutsch
      • Français
      • Nederlands
      • Russian
      • Italiano
      • Español
      • Polski
      • Português
      • Norsk
      • Suomen kieli
      • Magyar
      • Čeština
      • Türkçe
      • Dansk
      • Română
      • Svenska

      90,000 What Your Poop Tells You

      Vasudha Dhar, MD, Special to Everyday Health

      As a gastroenterologist, I am somewhat surprised that people do not pay more attention to their

      bathroom habits

      Denial While this is not the most enjoyable topic, it really isn’t easier to simplify your way of knowing what’s going on inside your body than seeing what’s coming out of it.

      One of the biggest misconceptions about our bowel movements is shared belief, which is the perfect result. Several years ago, a famous doctor suggested that we should all strive to see

      Ideal S.

      “And that something else might indicate some kind of problem.

      Following this announcement, my appointment calendar was booked in a few weeks. I explained to the concerned patients that, in fact, the doctor’s famous reporting statement was wrong.All GI Tract works in different ways based on a combination of constant and changing factors – genetics, hydration, dietary habits, medication use, and current health problems.

      Think about it – sometimes certain foods just don’t agree with you, and sometimes you don’t drink enough water. Or, you may be taking a new medication. These factors can change the consistency and caliber of your stools for a short time, but they usually come back up within a few days.

      The frequency of bowel movements also varies. Not everyone is connected to

      Bowel movement

      daily. Some people have one every few days, while other people go more than once a day. Regardless, both are normal.

      Bowel changes

      What’s important to know about how your GI tract normally functions and what your typical bowel activity is. If you’ve noticed a lasting change, here’s when you need to keep a close eye on what’s going on.Also, if you feel pain or other severe symptoms, it’s time to call your doctor.

      Keep in mind that if your stool changes for a week or longer, it doesn’t necessarily mean that your GI tract is a medical problem. I recently saw a female patient in her forties and forties who were worried that her stools had changed from regular to a more complex consistency, and the frequency had increased. She also lost weight.

      After starting her blood to work and doing other diagnostic tests, we learned that she had



      Inactive thyroid gland

      ), a state where


      produces too much

      thyroid hormone

      which causes symptoms, including increased metabolism (causing sudden weight loss), increased heart rate, sweating, and changes in bowel movements.

      5 signs of bowel problems

      The body has a way to express itself when there are problems inside by changing your bowel movements. Here are five warning signs you shouldn’t ignore:

      1. Blood in your stool.

        If you see even small amounts of blood in your feces on a consistent basis, see your doctor. Blood can be

        hemorrhoid sign

        or anal fissures

        Pre-cancerous colon polyps

        or inflammatory bowel disease (IBD).In the worst case, it could be

        cancer sign


      2. Changing the consistency of the stool.

        Everyone has bouts of diarrhea from time to time. But if you have had strong bowel movements and now often have diarrhea, it could be

        ulcerative colitis sign


        Crohn’s disease

        two types of IBD – especially if you also have

        abdominal pain

        , bleeding and weight loss.

      3. Color change.

        Bowel movements are usually brown in color due to the bile that is produced in the liver. If the stool is black, it could be a sign of internal bleeding. Green stools are usually nothing to worry about.

        Chair color

        Also changes depending on the types of food you eat.

      4. Constant diarrhea.

        Diarrhea can be a sign of infection or food intolerance.
        Ulcerative colitis

        And some other microscopic disorders of the colon can cause changes in stool frequency. It can also be the result of drug changes or irritable bowel disease.

      5. Constipation.

        If you have a new one

        onset of constipation

        This could be due to a lack of proper hydration or medication side effects.

        Irritable bowel syndrome



        ) can also be considered.If your symptoms do not improve a few days after increasing fluids, see a doctor.

      Better lifestyle, better gut

      People who deal with chronic bathroom problems should be evaluated by a doctor. Most conditions can be treated with medications and lifestyles. Irritable bowel disease is one of the most common conditions affecting the colon (colon). It causes cramps, abdominal pain,


      , gas, diarrhea and


      Withdrawal This is a chronic condition that you will need to manage long-term dieting, stress management, and medications.



      Problems can be solved with simple changes in your diet and lifestyle. For less severe cases, the following nutrition and exercise changes may be helpful:

      • Eat unprocessed, natural foods, including fiber-rich vegetables.
      • Avoid artificial sweeteners, fructose, chemical additives,


        excessive caffeine.
      • Boost your gut flora by adding naturally fermented foods to your diet – sauerkraut, pickles, and kefir.
      • Add


        Supplement if you are not getting enough good bacteria from your diet.
      • Aim to drink two liters of water a day.
      • Exercise regularly.
      • If you are using medication every day, ask your doctor if it may be affecting your bowel movements.
      • Take steps to minimize chronic stress.

      Be sure to talk to your doctor before making any changes to your healthcare routine. Pay attention to your bowel movements in the same way as you observe your weight, get confirmation of your blood pressure, and evaluate your heart rate estimate. Your bathroom habits may suggest warning signs that something may not be quite right and that you need to be checked by a medical professional.

      90,000 major changes + video with a breakdown from an expert.

      We are used to the fact that every year the hunting rules change slightly – the terms, wording and all sorts of little things are specified. However, the amendments from 2021 turned out to be so significant that we decided to prepare an article with an analysis of the most serious innovations.

      You can read the full text of the hunting rules here, but we will try to explain only the most important, in our opinion, changes.

      General provisions

      Most of the changes in hunting rules are aimed at combating poaching.Lawmakers tried to remove gray areas and ambiguous wording of the rules, but this led to their significant tightening. It is unclear whether these measures will help reduce the level of poaching, but all of us now have to endure the inconvenience.

      Formulation of concepts

      The most important and fundamental change is the clarification of the concept of “Hunting”. Now these are activities related to the search, tracking, pursuit of hunting resources, their extraction, primary processing and transportation.

      Hunting is equated to being in hunting grounds of individuals with hunting tools and (or) hunting products, hunting dogs, hunting birds, except for cases when officials are in hunting grounds with hunting firearms in the implementation of federal state hunting supervision and industrial hunting inspectors in the implementation of production hunting control

      That is, in other words, if you entered the territory with weapons (shrouded, disassembled) – you are already hunting, and all restrictions apply to you in full.On the one hand, this deprives poachers of the opportunity to avoid responsibility by fables about the fact that they “just walked” with weapons in the land. But on the other hand, it makes respectable hunters violators, if they cross the boundaries of some land plots in order to get to those in which they have a voucher.

      Also, you will become a violator if you arrive at the hunting grounds in advance – according to the new law, you will be considered a hunter outside the deadlines.

      The same applies to the entrance to hunting grounds with hunting birds and dogs of hunting breeds – even if you just took the dog out to run in a forest belt or fields, in the eyes of the hunting inspector it will be poaching, and it does not matter if you are a hunter or an ordinary lover of domestic animals.Keep this in mind, as some lands are close to settlements and public roads.

      Separately, it should be said about being in lands with hunting products. This means that if you, even without weapons, will be in the lands with the captured animals or their parts, then from the point of view of the law, you also hunted. The clause will complicate the life of unscrupulous hunters and poachers, who could previously hide weapons and refer to the fact that they accidentally found an animal they illegally obtained.But on the other hand, such a wording makes it possible to prosecute innocent people, for example, in theory, kebab lovers who decided to butcher and marinate meat on the spot – after all, many hunting grounds are adjacent to rivers and countryside recreation sites.

      Recording the fact of production

      This clause was in the rules before, but its implementation was often ignored due to the vague wording. Now everything is very clear and understandable – after mining and before starting any actions with mining, you must make a mark in the mining permit.The only exceptions are species of animals, for the production of which there are no restrictions.

      A note should be made before any manipulation of the game, as even picking up a duck from the water into the boat will be considered transportation.

      First recorded, then raised the catch

      Clarification of the wording will exclude cases when unscrupulous hunters deliberately did not make marks on the caught game before meeting with the inspector. Now they will directly violate the rules of hunting, fall under complete confiscation and be deprived of the opportunity to hunt animals with a small quota more than what is supposed to be.

      Also, in most cases, it is necessary to make a note about the injury of an animal before taking it, in more detail this is described in the requirements for hunting a specific group of animals.

      The powers of inspectors

      The powers of all inspectors have been significantly expanded. Hunting inspectors, as well as all officials authorized for inspection, upon presentation of a document, may require you to discharge and hand over weapons for inspection, show any documents, check your personal belongings and transport.

      This means that the hunter gets to the very bottom of the food chain, and almost everyone has the right to check him, but refusal to check may entail a decision to violate the rules of hunting, and the subsequent confiscation of weapons and hunting equipment.

      Inspection, inspection of personal belongings and weapons – all this is now in the powers of hunting inspectors

      Powers of governors

      Federal law gives the right to change its provisions in accordance with regional characteristics, that is, gives the governor of the region to interpret or change as he pleases hunting rules in their subject – up to a complete ban.It is impossible only to limit the types of weapons in excess of the restrictions of the federal law, as well as to extend the hunting period.

      For most regions, most likely, nothing will change, but there will probably be those in which the terms and rules will differ greatly from the federal ones. You may have seen something similar in some republics within the Russian Federation, but now this legislative experience has been scaled up to all regions.

      Safety and hunting at night

      Significant changes are related to safety in hunting.You may have noticed an increasing number of accidents on hunting from year to year – this is due to both the ignorance of elementary safety techniques by hunters and insufficient technical equipment.


      The worldwide practice has finally reached us – now all participants in a collective driven hunt are required to wear bright vests with reflective elements. Also, vests are now required to be worn by participants in night hunts, putting them on an hour before sunset, and taking them off an hour after sunrise.

      This measure should seriously reduce the number of victims of hunting accidents, although it will undoubtedly reduce the productivity of hunts from the concealment and on the bait, unmasking the hunter.

      Do not neglect bright clothes when hunting – no prey is worth your life and health

      A ban on shooting at flying up game

      Another new measure aimed at the safety of hunters is a ban on shooting at a bird taking off below 2.5 meters when hunting in thickets.It is not entirely clear why this prohibition applies only to a flying bird, we recommend not to shoot on our own either at landing or low-flying targets.

      Shooting near housing

      The wording of the ban on shooting closer than 200 meters from housing has been clarified – earlier it was not entirely clear what housing was, and unscrupulous inspectors could interpret this ban in their favor. Now the wording has gained transparency – it is forbidden to fire closer than 200 meters from residential buildings and residential buildings.

      Lighting devices

      Control over the use of lighting devices, on the other hand, has been substantially liberalized. Now hunting with thermal imagers, nightlights and flashlights is allowed not only from the tower, but also from the ground – from the approach or from an ambush. So you can get hoofed animals, bears, wolf, jackal, fox, raccoon dog, badger, beavers.

      It is still prohibited to use any lighting devices for the extraction of any feathered game.

      Add to favorites


      Remote warehouse

      Add to favorites


      Remote warehouse

      Add to favorites


      Remote warehouse

      Add to favorites


      Remote warehouse

      Add to favorites


      Remote warehouse

      Add to favorites


      Add to favorites


      Remote warehouse

      Add to favorites


      Add to favorites


      Show all

      Changes to the rules related to weapons

      In terms of the use of weapons, there are also many changes designed to complicate the life of poachers and unscrupulous hunters, but law-abiding hunters will receive pleasant surprises like the legalization of gun shooting.

      Zeroing weapons

      Previously, sighting weapons in hunting grounds could raise questions from the inspector, and in order to avoid a fine, one had to invent excuses like “shot at a partridge, but didn’t hit”. Now this procedure is legal, moreover, the reduction to normal combat is strongly recommended by the hunting rules.

      Zeroing in hunting grounds can only be carried out during the hunting period if the hunter has documents for the right to hunt. Of course, when zeroing in, the hunter must comply with all safety measures described in the hunting rules.

      Feel free to shoot your weapon in the lands to which you have a ticket!

      Ban on rifled weapons for poultry

      The ban on the use of bullet charges and buckshot more than 5mm on game birds existed before, now it has been significantly expanded by the ban on the use of any rifled weapon except in calibers .22 LR and .22 WMR , and only on hazel grouse, black grouse and wood grouse from the third Saturday of August to the last day of February.

      Add to favorites


      Add to favorites


      Remote warehouse

      Add to favorites


      Add to favorites


      Remote warehouse

      Show all

      It is forbidden to use any other rifled weapons, and moreover, being in the lands with such weapons with a permit only for birds will be regarded as a violation of hunting rules!

      Caliber restrictions

      Similar restrictions have appeared for other animals.So, for hunting hares, wild rabbit, corsac, squirrel, ermine, wild cats, striped raccoon, columnar, martens, flying squirrel, mink, saltongoi, harzu, trochee, you cannot use rifled weapons with a caliber of more than 5.7 mm., And for catch of marmots, beavers, badgers, wolverines, lynx no more than 8 mm.

      As in the case of game birds, being in the area with weapons that are not of the correct caliber for the animals in the permit will be considered a violation of hunting rules and will entail administrative liability.

      All the practical benefits of such restrictions are nullified by the fact that if you have a permit for a fox, you can stay in the lands with any caliber – for some reason, no restrictions apply to it.

      Changes and extensions of deadlines

      Changes in hunting dates for bows

      Great news for archers – although they are still in the gray zone, new legislation has taken care of preferences for them when bows do become fully legal.The timing of hunting ungulates, bears and fur animals can be set two weeks earlier than the federal hunting deadlines.

      Extension of the period of spring hunting for duck with decoy

      A significant relaxation awaits breeders of decoy ducks – for them the period of spring hunting increases to 30 days, against 10 days for all others.

      Other changes in hunting timing

      There are minor changes in hunting timing for other groups of animals, you can read more about them here.We remind you that the timing of hunting in your region may differ significantly from the general federal timing – you can see them here.

      Reference article based on author’s expert opinion

      Noonee Chairless Chair 2.0 exoskeleton review

      The new Chairless Chair 2.0 exoskeleton, manufactured by Noonee Germany GmbH, serves as a chair when needed, wherever you need it.


      Chairless Chair is another useful exoskeleton for your production that can help increase productivity by protecting staff from fatigue and injury, and reducing hospital and replacement costs.

      Find out more by reading the article.


      Photo source: Noonee


      Chairless Chair 2.0 is a “chairless chair” – a lightweight flexible exoskeleton that does not restrict movement while working, but can function as a chair. When it is not activated, you can walk in it normally and perform various production operations when you need it – it turns on with one press of a button and you can sit on it.

      The device itself does not touch the ground, which makes it easy to wear: a comfortable waist belt secures it to the lower back, and the straps cover the hips. The adjustable damper captures and supports body weight, which is directed towards the heels of the shoe. This allows the operator to fully distribute the operator’s load to the floor, while the two points of contact ensure a stable posture. The heel mounts in the first version of the exoskeleton were specially designed as part of the mechanism, the second uses an alternative version that works with any shoe and only touches the ground in a stationary (on) position.The user simply assumes the desired pose and then turns on the device.

      Creation history

      Keith Gunura, photo source: M. Brega / The Age of robots

      Keith Gunura, 29-year-old CEO and co-founder of startup Noonee, says:

      “The idea came about when I was 17 years old and working in a packaging factory in the UK. Because I wanted to sit wherever and whenever.Standing for hours on end causes great discomfort to the lower limbs, but most workers have very few breaks, and chairs are rarely provided because they take up too much space. So I thought it would be best to carry the “chair” right on top of me. ”

      Photo source: Noonee

      At the beginning of the journey, the startup received an investment from the Honda Xcelerator project, created to support new developments, and now operates in Germany as Noonee Germany GmbH.Chairless Chair 2.0 is the second version of the exoskeleton.


      Photo source: Noonee

      • Flexibility: The height of the seating position is easily adjustable for different purposes;
      • Prevention: fixing the posture in different positions allows you to perform different operations that are inconvenient to do while sitting or standing, and prevents injury;
      • Mobility: can be freely moved around the entire production or warehouse area, there is no need to have furniture for seating in all rooms or carry it with you;
      • Personalization: Individual settings are available for people of different heights and sizes.

      New CTO and co-founder of the project, Brian Anastasiadis, says:

      “Chairless Chair 2.0 not only rests the leg muscles, it also provides optimal posture, keeps your back straight and reduces the incidence of abnormal postures in both healthy workers and those recovering from muscle or joint injuries.”

      Photo source: M. Brega / The Age of robots

      Sammy Margot, Certified Physiotherapist:

      “As physical therapists, we actively encourage people to move throughout the day.This device looks like a great compromise, as it allows the wearer to move and sit periodically. It is not worth encouraging its use for prolonged sitting, but it is the most suitable for those people who need to move and rest periodically. ”



      Chairless Chair is of interest to the industry, and the previous version was tested in production at the BMW factory.

      And also in the production of Audi.

      91 090 Photo source: Audi

      A similar exoskeleton can be used in any production where human participation is required in direct assembly, adjustment or quality control.

      Photo source: M. Brega / The Age of robots

      And even in small workshops.

      Photo source: Noonee

      What is the use

      91 090 Photo source: Audi

      Continuous sedentary work is harmful, physical inactivity shortens life expectancy, but constant work while standing is also a source of problems.Physical stress, repetitive movements and poor posture can lead to musculoskeletal and neurological disorders, which are currently one of the main causes of injury and disability. In 2011, according to the US Department of Labor, such diseases accounted for 33% of all injuries and illnesses of workers in the United States, accounting for more than 378,000 cases. More than 40 million workers suffer from work-related musculoskeletal disorders, according to Fit For Work Europe survey, conducted in 23 European countries.

      Startup team testing prototypes, photo source: Noonee

      To maintain health, movement and relaxation are equally necessary, which the Chairless Chair is designed to provide.

      Photo: Noonee

      The frame made of aluminum and carbon fiber ensures lightness of the structure – the total weight of the exoskeleton is about two kilograms, so it does not burden the user with great excess weight and practically does not hinder movement.

      Keith Gunura, Startup Founder says:

      “A chair without a chair” can add to your daily life as well – imagine wearing it on a crowded train – it would make commuting to work that much more comfortable.

      Photo source: Noonee

      We also think about the people behind the counter, in the service and retail sectors, the farmers picking fruit, and even the surgeons in the operating room. In many cases where a regular chair would be impractical and inappropriate, a Chairless Chair can be of great benefit.»

      Where To Buy Chairless Chair 2.0

      Order Chairless Chair 2.0 in Top 3D Shop – the online store of Top 3D Group, the leading integrator of robotics and additive technologies in Russia according to 3D Print Awards 2018.

      Find out more about opportunities to improve your production by integrating new equipment:

      Meaning, Definition, Suggestions.What is a change in weight

      So subtle that a slight change in weight and pressure can destroy it.
      The problem is that in some cases the gradient will be vanishingly small, effectively preventing weight changes.
      Fetta theorized that when the device is activated and pulls upward, the strain gauges will detect thrust as a change in weight.
      Other results
      This explains weight loss, salt cravings, behavioral changes, muscle weakness.
      Developing countries, where political change is not uncommon and does not have sufficient negotiating weight, face a serious risk of inconsistent IIAs.
      ensure that the introduction of new business models, coupled with the increased share of ICT in program delivery, is accompanied by structural change;
      This explains weight loss, salt cravings, behavioral changes, muscle weakness.
      I would like to personally check incision locations, weight changes, patient sugar levels.
      Changes in caliber or sudden changes in bullet weight and / or velocity require a change in spring weight or slip mass to compensate.
      Lifestyle changes may include compression stockings, exercise, leg lifts, and weight loss.
      Lifestyle changes include weight loss, reduced salt intake, exercise, and a healthy diet.
      This happens by reducing weight or changing the trajectory of movement.
      In many styles of salsa dance, when the dancer moves his weight in steps, the upper body remains level and almost unaffected by weight changes.
      In many styles of salsa dance, when the dancer moves his weight in steps, the upper body remains level and almost unaffected by weight changes.
      In the original Latin American form, salsa moves forward / backward diagonally or sideways while maintaining a three-step weight change.
      Signs and symptoms may include blood in stools, changes in bowel movements, weight loss, and feeling tired all the time.
      A dynamic MST task deals with updating a previously computed MST after changing the weight of an edge in the original graph or inserting / removing a vertex.
      The leading hypothesis for this change towards early puberty is improved nutrition resulting in rapid body growth, weight gain, and fat storage.
      Treatment for NAFLD usually consists of dietary changes and exercise to achieve weight loss.
      An intuitive explanation for this formula is that the change in pressure between two heights is due to the weight of the fluid between the heights.
      Diet and lifestyle changes are effective in limiting excessive weight gain during pregnancy and improving outcomes for both mother and baby.
      Assuming that humans have a soul and animals do not, McDougall later measured the weight changes in fifteen dogs after death.
      Moderate complex lifestyle changes on site result in more weight loss than conventional care, averaging 2 to 4 kg over 6-12 months.
      He attributed his change in appearance to three plastic surgeries, puberty, weight loss, a strict vegetarian diet, a change in hairstyle and stage lighting.
      The critical frequency of torsional vibration will change when the weight of the connecting rods, pistons and crank weights changes.
      While restoring a person’s weight is the primary goal at hand, optimal treatment also includes and monitors changes in a person’s behavior as well.
      However, these changes appear to be associated with acute malnutrition and are largely reversible with weight recovery, at least in non-chronic cases in young adults.
      Possible signs and symptoms include swelling, abnormal bleeding, prolonged cough, unexplained weight loss, and changes in bowel movements.
      This independent weight loss benefit is associated with a decrease in stomach volume, changes in intestinal peptides, and the expression of genes involved in glucose uptake.

      Leave a Reply

      Your email address will not be published.