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Stool frequency is associated with gut microbiota composition
  1. Fatemeh Hadizadeh1,2,
  2. Susanna Walter3,
  3. Meriem Belheouane4,5,
  4. Ferdinando Bonfiglio1,
  5. Femke-Anouska Heinsen6,
  6. Anna Andreasson7,8,
  7. Lars Agreus7,
  8. Lars Engstrand9,10,
  9. John F Baines4,5,
  10. Joseph Rafter1,
  11. Andre Franke6,
  12. Mauro D'Amato1,11
  1. 1Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
  2. 2School of Nutrition, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3Division of Gastroenterology, Institution of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
  4. 4Max Planck Institute for Evolutionary Biology, Plön, Germany
  5. 5Institute for Experimental Medicine, Christian-Albrechts-University of Kiel, Kiel, Germany
  6. 6Institute of Clinical Molecular Biology, Kiel University, Kiel, Germany
  7. 7Division for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
  8. 8Stress Research Institute, Stockholm University, Stockholm, Sweden
  9. 9Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
  10. 10Clinical Genomics Facility, Science for Life Laboratory, Stockholm, Sweden
  11. 11BioCruces Health Research Institute and IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
  1. Correspondence to Professor Mauro D'Amato, BioCruces Health Research Institute, Cruces University Hospital, Barakaldo 48903, Spain; mauro.damato{at}, mauro.damato{at}

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We read with great interest the two recent communications by Vandeputte et al1 and Tigchelaar et al,2 which reported an association between stool consistency and gut microbiota composition. Both studies focused on stool consistency, based on the Bristol Stool Scale (BSS) as the main trait, due to its reported correlation with colonic transit time (CTT) that is of clinical relevance for several GI conditions. However, stool frequency, another feature of human bowel function that is easy to measure and record, has also been shown to correlate with CTT,3 ,4 although to a lesser extent than stool form, and has not yet been investigated in relation to microbiota composition.

We examined the association between gut microbiota and stool frequency in the Population-based Colonoscopy study, a general population-based cohort from Stockholm, Sweden, previously described in detail.5 Sixty-nine individuals (21 males and 48 females, aged 55.6±10.33) with available frozen faecal samples and daily recordings of defaecation …

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  • Contributors MD had the original idea, and designed the study together with AF; SW, AA, LE and LA collected material, characterised the study subjects and acquired data; F-AH, AF and JFB performed microbiota sequencing; data analysis and interpretation were done by FH, MB, FB, JR and MD. FH, MD and JR drafted the manuscript with critical revision from all authors.

  • Funding Supported by funds from the Swedish Research Council (Vetenskapsradet) to MD; European Union Seventh Framework Programme (FP7/2007-2013, grant number 262055, ESGI) to MD and AF; Iranian ministry of health and medical education to FH.

  • Competing interests None declared.

  • Ethics approval Karolinska Institutet, Stockholm, Sweden.

  • Provenance and peer review Not commissioned; internally peer reviewed.