Hard stools are a common occurrence. They occur when stools pass through the colon too slowly, allowing the colon time to absorb too much water from the stool. The stools then become hard and dry.

Hard stools are common, and most people experience them occasionally. Around 16 out of 100 adults and roughly one-third of adults aged 60 years and older have symptoms of constipation.

Hard stools may be attributable to lifestyle factors, such as a person’s diet, activity levels, or medications they may take. Hard stools may also occur due to certain 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.

This article explains what causes hard stool, how to treat constipation, and when to speak with a doctor. It also provides information on the effects of hard stools in children and babies.

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 hard, dry stools that can be difficult to pass.

Most healthy people have a bowel movement between three times per day and three times per week. A person’s typical bowel movement pattern may slow down when the body digests food inefficiently. The longer the stool remains inside the colon, the harder it may become.

Some symptoms of constipation include:

The Bristol stool chart can help people identify problems with bowel movements by comparing the shape and consistency of their stool.

Various issues can slow digestion and harden the stool.

Some of the most common causes include:

  • Aging: As a person ages, changes in the body can cause constipation. A 2021 review found that the most common causes of constipation in older adults are reduced physical activity and taking multiple medications. An older 2015 study found that constipation in older adults could be due to pelvic floor dysfunction.
  • 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 sugar intake 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 the blood supply to the gut, leading to slower movement of food through the digestive tract.
  • Pregnancy and childbirth: Some females may experience hard stools during pregnancy or following childbirth. This can be due to fluctuating hormone levels and other changes in a person’s body, such as increased pelvic floor pressure.
  • Toilet training anxiety: Some young children get anxious about toilet training and may 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 to pass. Children who become very constipated may experience fecal incontinence.
  • Irritable bowel syndrome (IBS): IBS 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: A 2021 study found that taking multiple pain medications is a significant risk factor for drug-induced constipation.
    • Radiation therapy: A 2017 study found that almost half of people receiving pelvic radiation experienced constipation during treatment and up to 10 days after treatment.

Certain lifestyle choices can help people avoid constipation.

  • Eat a high fiber diet rich in fruits, vegetables, whole grains, legumes, and nuts.
  • Avoid low fiber, nutrient-poor foods, such as fried foods, fast foods, and highly processed meals and snacks.
  • Drink plenty of water, naturally sweetened fruit and vegetable juices, and clear soups to stay hydrated.
  • Get plenty of daily physical activity.
  • Aim to have a bowel movement at the same time each day.

Read about foods that can cause constipation.

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

  • Taking laxative medications: Various constipation medications may help with passing hard stool, including:
    • osmotic laxatives
    • emolient laxatives or “stool softeners”
    • bulk-forming laxatives
  • Making dietary changes: A high fiber diet including lots of fruits and vegetables can make stools easier to pass.
  • Drinking plenty of water: Drinking more water can help soften stool.
  • Receiving an enema: An enema involves inserting liquid or gas into the rectum to empty the bowels or administer medication. Enemas add water to the stool and can stimulate the impulse to poop.
  • Taking supplements: A 2019 study found that magnesium supplements improved helped relieve constipation.

Read more about home remedies for constipation.

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 a partial intestinal blockage. The blockage can cause pain, which may lead to fecal incontinence. It may also impair a child’s ability to detect when they need to use the bathroom.

Parents and caregivers should talk with a doctor before giving a child constipation medication. Some of these drugs contain ingredients that may not be safe for children and babies.

While waiting to speak with a doctor, the following practices may help:

  • Making regular bathroom visits: Take the child to the bathroom at regular intervals may encourage them to poop.
  • Offering positive reinforcement: Allow the child to do something fun while sitting on the toilet to help the child view toileting as a positive experience. This may alleviate any anxiety they have about toileting.
  • Avoiding punishments: People should avoid getting angry or punishing a child for toileting accidents. Constipation is not the child’s fault, and scolding the child will only increase their anxiety about toileting, potentially making constipation worse.
  • Ensuring good hydration: People should offer the child plenty of water and avoid giving them sugary snacks and fruit juices.
  • Offering fruit: Giving a child fruit can help soften bowel movements. Prunes are a particularly good option as they are high in fiber. People should avoid giving bananas, as they can worsen constipation.
  • Encouraging movement: Moving a baby’s legs in a bicycle motion may helo them have a bowel movement.

Learn about home remedies for baby constipation.

Occasional constipation is common and does not necessarily indicate an underlying health issue. However, a person should speak with a doctor if they experience any of the following:

  • hard stools that last longer than a week or are a recurring problem
  • hard stools that cause bleeding or pain
  • hard stools that develop after starting a new medication

A parent or caregiver should also notify a doctor if a child cannot pass stool for several days or if the child seems very distressed due to hard stools.

Chronic, untreated constipation may lead to complications, so a person must receive prompt treatment for hard stools.

Read about the possible risks of chronic constipation.

Hard stools occur when food passes too slowly through the colon. They can be painful and unpleasant for adults and children alike. In children, hard stools may also lead to fecal incontinence and delay toilet training.

Infrequent hard stools are usually just an inconvenience. People who experience this symptom from time to time may find it beneficial to drink more water, eat more fruit and fiber, and perform more exercise.

When hard stools become a chronic problem, it is important to see a doctor. The right treatment can quickly resolve the issue and may prevent serious complications.