Hard Poop: Causes and Treatment for Constipation
There are a number of easy fixes to address this uncomfortable issue
Medically reviewed by Jay N. Yepuri, MD
Hard stool happens when your colon absorbs too much water from your stool. This can occur with or without constipation. Some people experience bowel movements that alternate between hard poop and softer poop.
Most people experience hard stools from time to time. For some, though, it's a long-lasting problem. Fortunately, it can often be prevented by making simple lifestyle changes, like eating more fiber and drinking more fluids.
Read on to learn more about what causes hard stools, what you can do to soften them up, and tips to prevent them.
Symptoms
Hard stool is a symptom of constipation, though it is also possible to have hard stools with regular bowel movements. When you have constipation, you may experience additional symptoms such as:
Having fewer than 3 bowel movements a week
Abdominal bloating and pain
Straining
Pain during bowel movements
Rectal bleeding
Difficulty or inability to pass stool
Healthcare providers usually define constipation as having fewer than three bowel movements a week. Chronic constipation is when your symptoms continue for at least three months.
What Causes Hard Stool?
Stools become hard when they don't contain enough water. This can happen if it takes too long for the stool to travel through your large intestine.
Your large intestine, or colon, is about five feet long. When you eat, your small intestine absorbs the nutrients from your food. It sends the leftover liquid and fiber to your large intestine. As matter winds its way through, your colon soaks up the excess liquid. The more time the stool spends in the colon, the more liquid is lost.
Common Causes
Hard stool and constipation are common; most people will experience them at some point in life. Some of the reasons why you might have hard stool include:
Dehydration: If you don't drink enough liquid, your colon will absorb too much fluid from your stool, causing hard stools.
Diet: Fiber absorbs water and helps food move through your digestive tract. If you don't get enough fiber in your diet, your stools won't absorb as much water and may become hard.
Sedentary lifestyle: Exercise helps food move through your digestive system more quickly.
Medication: Certain medications such as antidepressants and opioid pain relievers may slow digestion. One of the most common causes of constipation in older adults is medication use.
Pregnancy: Fluctuating hormone levels during pregnancy can cause changes in your body leading to hard stools.
Irritable bowel syndrome (IBS): IBS is a common cause of constipation and hard stools. People with IBS may experience mostly constipation, mostly diarrhea, or a combination of both.
Why is my poop hard at first then soft?
Alternating constipation and diarrhea can occur with irritable bowel syndrome (IBS). If you have frequent bouts of diarrhea and/or constipation, talk to your healthcare provider.
Less Common Causes
Less commonly, hard stool can be related to other factors such as a specific medical condition.
Hypothyroidism: People with hypothyroidism don't produce enough of the hormones that regulate digestion. This can lead to constipation.
Neurological conditions: Parkinson's disease, brain injury, and other conditions that affect the nervous system may lead to problems with digestion.
Mental health conditions: Certain mental health conditions like depression and anxiety are associated with constipation and hard stool. The medications prescribed to treat these conditions may contribute to this symptom.
Dementia: People experiencing cognitive decline or dementia, including Alzheimer's disease, may have less frequent bowel movements and constipation.
Cancer: Cancer of the lower GI system can cause constipation. People with cancer also tend to have additional symptoms such as chronic pain, blood in the stool, and fatigue. Cancer therapies such as radiation may also cause constipation as a side effect.
Takeaway
People who have IBS with constipation (IBS-C) experience infrequent bowel movements. Some people with IBS may mischaracterize their bowel problems as constipation because they have hard stools, even if their bowel movements are regular.
If you have IBS, be sure to tell your healthcare provider if your stools are frequent or infrequent as well as whether they are hard or soft. Your diagnosis affects your treatment. For example, if your problem is infrequent stools, your treatment is different than for people who have hard stools but are regular.
Treatment
Pooping between three times a day and three times a week is normal. Most people have a set bowel movement pattern. Infrequent bowel movements are a common cause of hard stools. If you experience constipation often, you should see your healthcare provider and find out what may be causing the problem.
You may feel uncomfortable talking about your symptoms, but you need to be specific. It helps to keep a journal of your bowel movements and symptoms to show your healthcare provider. An accurate diagnosis is essential in coming up with the proper treatment.
If your healthcare provider says constipation is your problem, you may want to ask about self-care for constipation and treatment for chronic constipation.
Don't Strain
To make hard stools easier to pass, sit on the toilet with your back straight and your elbows on your knees. Your legs should be apart and your knees should be higher than your hips (a footstool can help). Take a deep breath and push your stomach muscles forward. Relax your anal sphincter, take another deep breath, and push down.
When Necessary, Use a Stool Softener
Stool softeners are over-the-counter products that soften the stool and help you go. They reduce the amount of fluid that your intestines absorb and leave more water in your stool. They trigger a bowel movement within 12 to 72 hours.
The primary ingredient in over-the-counter stool softeners is docusate sodium. Common brand names of these products include:
Colace
Correctol
Diocto
Doxinate
Ex-Lax
Fleet
Modane Soft
Phillips' Stool Softener
Surfak
Stool softeners are a form of stimulant laxative that are generally considered a safer option, but only when used now and then.
Psyllium is a natural, soluble fiber that comes from the seeds of plants in the genus Platago. Some studies have shown that taking psyllium works better than stool softeners. Psyllium can also help lower cholesterol levels.
Complementary and Alternative Therapies
Abdominal self-massage has been studied as a treatment for constipation. It may stimulate the muscles involved in producing bowel movements and reduce stress.
Biofeedback can also help people with constipation. Biofeedback is a mind-body therapy that helps you learn to control how your body functions.
Many healthcare providers recommend probiotics for patients with constipation. However, a review of 18 studies found there's not enough evidence to show this is helpful. Other alternative therapies that have not been proven to work include acupuncture and acupressure.
Medical experts warn against using natural products marketed as laxatives. That's because their dosage and purity might not be safe. They can also interact with other medications you may be taking.
Seek Medical Treatment From Your Healthcare Provider
If you continue to have constipation and hard stools, working with your healthcare provider is a good idea. Your healthcare provider can recommend stool softeners and various types of laxatives, both over-the-counter and prescription.
They can also make sure that these medications don't interfere with ones you may already be taking. There are other medications your healthcare provider can prescribe, including Amitiza (Lubiprostone) and Linzess (Linaclotide), that draw water into your intestines.
Prevention
Hard stools can often be prevented with simple remedies like changing what you eat and drink. Most people can successfully prevent hard stools at home, but if your problem persists, you should see your healthcare provider.
Use the tips below to help prevent hard stools. These tips cover hard stools with and without constipation.
Add Fiber to Your Diet
There is some evidence that increasing soluble fiber may prevent hard stools. It's recommended that adults should get between 25 and 31 grams of fiber each day. However, studies show most Americans fall far short of this and get an average of about 16 grams of fiber a day.
Soluble fiber dissolves in water, softening the stool. You can increase your soluble fiber by eating most fruits, vegetables, beans, and whole grains. Flaxseed, chia seeds, and psyllium are other good sources of soluble fiber.
Drink More Water
You've probably heard many times that staying hydrated is essential. When you don't drink enough fluids, your body draws more water out of your stool. This causes hard stools.
Healthcare providers generally recommend that adults should drink:
About 15.5 cups of fluids a day if you're a man
About 11.5 cups of fluids a day if you're a woman
Takeaway
One of the easiest things you can do to keep your stool soft is to keep a water bottle nearby and drink water throughout the day. You might also need to cut back on how much caffeine and alcohol you drink.
Alcohol and caffeine can cause dehydration. So if you choose to have a beer, glass of wine, or an extra cup of coffee, follow it up with a nice, tall glass of water.
Related: Simple Tricks to Drink More Water
Pay Attention to Urges to Go
If you're like many people, you put off bowel movements during the day. There are lots of reasons for doing this. You don't want to go to the bathroom at work. You're too busy. You prefer going in the comfort of your own home.
However, hard stools are a sign that your poop is spending too much time in your colon. So tune in to your body's needs and go when you have to. If you want to avoid going at work, there are ways to retrain your bowel. They include sticking to set meal times and scheduling your bowel movements for a specific time each day.
Complications of Hard Stools
Hard stools can lead to straining while you poop. Besides being uncomfortable, this can cause hemorrhoids and anal fissures, tears in the lining of the anus. Straining to pass hard stools can even cause rectal prolapse, where part of the large intestine slips out of your anus.
Summary
Hard stools occur because your colon absorbs too much water from your stool. This can happen if it takes too long for liquids and fiber to move through your colon. It can also occur if you put off having a bowel movement.
To prevent hard stools, listen to your body and poop when you need to go. It's also important to get plenty of fiber and stay hydrated. This may require cutting back on caffeine and alcohol. These drinks can cause you to become dehydrated.
Most people experience hard stools at some point. Over-the-counter stool softeners are safe to use every once in a while. Studies show products with psyllium may work even better.
Read the original article on Verywell Health.
