Hard Stool and how can you treat it?
Dr. Mayank Agarwal

Stools may sometimes pass through the colon too slowly, allowing the colon time to absorb too much water from them. The stools may then become hard and dry and be painful or difficult to pass.

The large intestine, or “colon,” absorbs water from the food that passes through it during digestion. When food moves too slowly through the colon, the colon can absorb too much water from the stool. This results in stools that are hard, dry, and difficult to pass.

Most healthy people have a bowel movement between three times a day and three times a week. When the body digests food inefficiently, a person’s typical bowel movement pattern may slow down. This can result in hard stool that is difficult to pass. The longer the stool remains inside the colon, the harder it may become.

Some symptoms of constipation include:

  • hard, lumpy stool
  • abdominal bloating
  • abdominal pain
  • feeling the need for a bowel movement but being unable to pass one
  • straining to have a bowel movement
  • pain when passing stool
  • bleeding when passing stool
  • being unable to pass an entire bowel movement
  • having fewer than three bowel movements per week

Causes

Various issues can slow down digestion and harden the stool.

Some of the most common causes include:

  • Aging: As a person ages changes in the body can cause constipation.
  • Diet: If a person does not consume enough fiber, such as fruits and vegetables, it may lead to constipation. This is because fiber promotes the movement of food through the digestive tract and absorbs water to soften stool. Food sensitivities and a high intake of sugary foods may also cause constipation.
  • Dehydration: Inadequate water intake (dehydration) is also a major cause of constipation. The intestines and colon absorb water from the stool to hydrate the body. If there is insufficient water available, stools will become hard and lumpy.
  • Lack of physical activity: Lack of physical movement affects blood supply to the gut, leading to slower movement of food through the digestive tract.
  • Pregnancy and childbirth: Some women may experience hard stools during pregnancy or following childbirth. This can be due to fluctuating hormone levels and other changes in a woman’s body, such as increased pelvic floor pressure. 
  • Toilet training anxiety: Some young children get anxious about toilet training, especially if their parents or caregivers become cross or impatient. They may develop a tendency to retain their bowel movements until they become too painful to pass.
  • Anxiety and trauma: Children sometimes avoid pooping because of anxiety, trauma, or a change in their bathroom routine, such as when they start a school term. This avoidance can cause hard stools that are difficult for the child to pass.
  • Irritable bowel syndrome (IBS): This chronic condition may cause alternating bouts of constipation and diarrhea.
  • Chronic medical conditions: Many medical conditions may cause chronic constipation, including:
  • Medications: Certain medications may slow digestion, such as:
    • Antidepressants: Tricyclic antidepressants can disrupt normal functioning of the digestive tract.
    • Some pain relievers: 
    • Radiation therapy:

Treatments and home remedies

Numerous remedies may help with hard stool and constipation, including:

  • Taking laxative medications: Various constipation medications may help with passing a hard stool, including:
    • Osmotic laxatives: These laxatives draw water into the colon, which helps to soften stool. Polyethylene glycol is a first-line osmotic laxative for constipation in adults and children. Lactulose is another common option.
    • Emolient laxatives or “stool softeners”: These medications help draw water into the stool, making it softer and easier to pass. Stool softeners are safe for most people, including pregnant women and older adults.
    • Bulk-forming laxatives: These laxatives increase the weight of stools, thus stimulating the bowels and making the stools easier to pass. An example is methylcellulose (Citrucel).
  • Making dietary changes: A diet that is high in fiber can make stools easier to pass. Fruits and vegetables are examples of foods that are rich in fiber.
  • Drinking plenty of water: Drinking more water can help soften the stool.
  • Receiving an enema: An enema involves inserting liquid or gas into the rectum in order to empty the bowels or administer medication. Enemas add water to the stool and can stimulate the impulse to poop.
  • Taking supplements: Some people may find that magnesium supplements help relieve their constipation.
    • the Bristol stool form scale
    • colonic transit time
    • spontaneous bowel movement

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