One month stool and laxative calendar (2142)

Key points below


Have this calendar with you when you call the clinic and when you come to your next visit.
List all fecal soiling accidents.  If there is room, record the laxative dose given each day.  Record all stools for one month. Include the size (large, medium, small), and the consistency of the stool (use the scale on the back of this sheet)

 

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Bristol chart