Constipation can cause hard, dry stools that are painful or difficult to pass. Hard stools are common, and most people experience them occasionally.
However, approximately 20% of people experience more frequent constipation. There are many different possible causes, ranging from a person's diet or medications to various medical conditions, such as irritable bowel syndrome (IBS) and diabetes.
In most cases, people can use home remedies to help soften the stool and ease constipation.
In this article, we explain what causes hard stool, how to treat constipation, and when to see a doctor.
As the body digests a meal, the food moves through the colon, which absorbs excess water from it. When the food moves too slowly, the colon can absorb too much water, resulting 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 normal pattern of bowel movements might slow down. When this causes a hard stool, a person may struggle to poop. While it remains in the colon, the stool may become even harder.
Some symptoms of hard stool include:
- feeling the need for a bowel movement but being unable to pass one
- straining to have a bowel movement
- pain on passing stool
- bleeding when passing stool
- being unable to pass an entire bowel movement
- abdominal pain
The Bristol stool chart can people to identify problems with bowel movements through the shape and consistency of their stool:
Many different issues can slow down digestion, hardening the stool. Some of the most common causes include:
- Aging. As a person ages, changes in the body can cause constipation. Pelvic floor damage can weaken a person's muscles, while nerve damage may also make it more difficult for them to pass a bowel movement.
- 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. Children who become very constipated may have accidents.
- IBS. This chronic condition may cause alternating bouts of constipation and diarrhea.
- Chronic medical conditions. A wide range of medical conditions, including diabetes, Alzheimer's disease, Parkinson's disease, hypothyroidism, and cancer, may cause chronic constipation.
- Medication. Certain medications, such as antidepressants and some pain relievers, may slow digestion. Radiation therapy may also have this effect.
- Diet. A diet that is very low in fiber may cause constipation. This is because fiber promotes the transit of food through the digestive tract and absorbs water to soften stool. Dehydration, food sensitivities, or a high intake of sugary foods may also cause constipation.
- Pregnancy and childbirth. Fluctuating hormone levels and changes in a woman's body, such as increased pelvic floor pressure, may cause hard stools during pregnancy or following childbirth. Learn more about constipation during pregnancy here.
Numerous remedies may help with hard stool and constipation. They include:
- Laxative medications. Various constipation medications may help with passing a hard stool. For example, research has shown the generic drug polyethylene glycol, which is an osmotic laxative that softens stool, to be safe and effective in adults and children. Laxatives that work by increasing the bulk of stool or stimulating the muscles of the gut are also available.
- Dietary changes. Eating high fiber foods can make it easier to pass hard stools. Fruits and vegetables are examples of foods that are rich in fiber.
- Water. Drinking more water can help soften the stool.
- Stool softeners. These medications prevent the colon from absorbing too much water from the stool. This helps keep the stool soft, making it easier to pass. Stool softeners are safe for most people, including pregnant women and older adults.
- Enemas. Enemas add water to the stool and can stimulate the impulse to poop.
- Supplements. Some people with constipation may get symptom relief from magnesium supplements.
Excessive use of certain medications, including enemas and laxatives, can cause chronic constipation.
It is important to avoid using medication for longer than a few days. If constipation persists, a person should consult a doctor.
Many babies and children experience hard stools. The pain of passing the stool may cause a child to avoid having a bowel movement, which can make the problem worse.
Severe, chronic constipation in a child or baby can cause encopresis. Encopresis causes very hard stools to block the intestines partially. This blockage can cause pain, and it may lead to incontinence or impair a child's ability to detect the need to use the bathroom.
Parents and caregivers should talk with a doctor before giving a child constipation medication. Some of these drugs, including enemas, often contain ingredients that may not be safe for children and babies.
While waiting to see the doctor, the following practices may help:
- Taking the child to the bathroom at regular intervals to encourage them to go.
- Allowing the child to do something fun while sitting on the toilet.
- Avoiding punishing a child for any toileting accidents and not displaying anger. Constipation is not the child's fault, and anger can make the problem worse.
- Offering the child plenty of water and ensuring that they avoid sugary snacks and fruit juices.
- Giving the child fruit, especially prunes, which can soften bowel movements. Learn more about prunes and prune juice as a remedy for constipation. However, avoid bananas, as they can cause or worsen constipation.
- Encouraging the baby or child to move. Babies may have a bowel movement if parents or caregivers move their legs in a bicycle motion. Find out about more home remedies for constipation in babies here.
Occasional constipation is common and does not necessarily indicate an underlying health issue. However, it is best to see a doctor when:
- hard stools last longer than a week or are a recurrent problem
- a child cannot pass stool for several days
- hard stools cause bleeding or pain
- a new medication causes hard stools
- a baby or young child seems very distressed as a result of hard stools
Hard stools can be painful and distracting. Children may find them embarrassing and scary, while parents and caregivers may worry about the effects of hard stools on toilet training.
Infrequent hard stools are usually just an inconvenience. People who experience this symptom from time to time may find it beneficial to eat more fruit and fiber.
When hard stools become a chronic problem, it is important to see a doctor. The right treatment can quickly resolve the issue, and it may prevent serious complications.