Barr et al developed a scale for grading stool retention in children based on plain X-ray films of the abdomen. This can be used for initial evaluation of the child and for evaluating the effectiveness of interventions. The authors are from the Boston Children's Hospital Medical Center and Harvard Medical School.
Method: A plain X-ray film of the abdomen. The method could also be applied using ultrasound or MRI scans.
Parameters – quantity:
(1) stool in ascending colon
(2) stool in transverse colon
(3) stool in descending colon
(4) stool in rectum
Parameters – quality:
(5) rock-like stools
(6) granular stools
|
Parameter |
Finding |
Points |
|
stool in ascending colon |
small amount |
0 |
|
|
moderate amount |
1 |
|
|
large amount |
2 |
|
stool in transverse colon |
none |
0 |
|
|
little |
0 |
|
|
moderate amount |
3 |
|
|
large amount |
4 |
|
|
large and dilated |
5 |
|
stool in descending colon |
none |
0 |
|
|
little |
0 |
|
|
moderate amount |
3 |
|
|
large amount |
4 |
|
|
large and dilated |
5 |
|
stool in rectum |
none |
0 |
|
|
little |
0 |
|
|
moderate amount |
2 |
|
|
large amount and full distally |
5 |
|
rock-like stools |
none |
0 |
|
|
few |
0 |
|
|
moderate amount |
1 |
|
|
large amount in transverse/descending colon |
2 |
|
|
large amount in ascending colon |
3 |
|
granular stools |
none |
0 |
|
|
little |
0 |
|
|
moderate amount distal |
2 |
|
|
large amount distal |
4 |
|
|
throughout length of colon |
5 |
rating score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 25
• The higher the score, the more the fecal retention.
• Different cutoff scores can be used. If a score >= 10 is used as positive, then 80% of children with stool retention and 90% of children not retaining stools are correctly identified.
Specialty: Gastroenterology
ICD-10: ,
