A new study published in Pediatric Gastroenterology, Hepatology & Nutrition aimed to determine whether modified Bristol stool form scale (m-BSFS) is a reliable tool to facilitate detection of constipation; and the agreement between stool form by m-BSFS and hard stool criteria in Rome. Here, a survey tool with the Rome III criteria and the m-BSFS was developed. A Likert-scale addressed frequency of each stool form on the m-BSFS. Responses to Rome III and m-BSFS were compared. The results showed that the sensitivity and specificity of the m-BSFS was 79.2% and 66.0% respectively; and in children <4 years of age, these improved to 81.2% and 75.0% respectively. There were sparse similarities between hard stools by m-BSFS and the painful or hard bowel movement question of Rome Criteria. The findings suggested the potential utility of m-BSFS as a reasonably good tool to facilitate the diagnosis of potential constipation in children. The inconsistency between painful or hard stool question in Rome III and ratings for hard stool on the m-BSFS illustrates that ones perception may differ between a question and a picture. Hence, it was concluded that a useful pictorial tool to appraise stool form may be a favorable in the process of enquiry about bowel habits in child care.