The hard stools are a symptom often associated with reduced frequency of defecation (constipation). Their evacuation is difficult or incomplete and involves other ailments, such as a sense of heaviness and abdominal swelling.
In most cases, hard stools are caused by inadequate nutrition, in particular by low fiber consumption, by the habit of drinking little and by rushing to the table. This manifestation can also represent a consequence of a sedentary lifestyle, stress, or the tendency to postpone the urge to go to the bathroom.
Hard stools can also be related to taking certain medications and diseases, such as diabetes, irritable bowel syndrome (IBS), or diverticulosis. If the problem recurs frequently or does not resolve itself within a few days, it can signal the presence of more severe disorders of the gastrointestinal system, which must be investigated with careful medical evaluation.
What is meant by Hard Stool?
The stools are hard when they are dry and with a consistency that makes expulsion difficult.
In general, hard stools occur in people suffering from constipation (or constipation ), since the persistence of the fecal material in the intestine subjects the latter to the risk of dehydration.
Hard stools can also form as a result of the occasional evacuation, but they can also represent an indication of pathological conditions, affecting the gastrointestinal system, such as irritable bowel syndrome or colitis, or other systems of the body.
When hard stools occur sporadically and resolve in a few days, they should not be a cause for concern and, often, there is no need to resort to special care: better eating habits are usually enough to solve the problem.
In some cases, however, hard stools can become a recurrent condition and, if associated with other pathologies, require targeted treatments for their solution.
Causes and Risk Factors
Feces are waste products of the organism which, after accumulating in the intestine, are expelled rectally. Their consistency basically depends on eating habits and the functionality of the subject’s gastrointestinal system.
The hard stools are difficult to expel , often remain locked in the intestinal tract and can lead to constipation . This symptom is mostly attributable to a lack of fluids in the enteric canal or to a decrease in bowel movements . However, the factors that can contribute to this problem can be many and varied.
What causes do hard stools cause?
In most cases, hard stools are a short-lived problem, related to constipation secondary to a series of unregulated eating habits .
Hard stools can be caused, in particular, by:
- Change of diet (for example, for a trip);
- Low fiber consumption;
- The habit of drinking little;
- Hurry at the table;
- Meals at always different times;
- Diet rich in animal fats and sugars.
Even poor physical activity can determine, in the long run, the appearance of hard stools: if the muscles of the intestine lose tone and relax excessively, it may be difficult to expel the mass of fecal material.
They can also contribute to the onset of this problem:
- Irregular sleep-wake rhythms ;
- The tendency to postpone the urge to evacuate or repress it when it occurs (over time, this incorrect habit can lead to a slowdown of intestinal transit);
- Habit to linger for a short time in the bathroom.
At other times, hard stools are not a transient phenomenon, that is, they do not regress within a few days; in these cases, their manifestation can signal the presence of more severe disorders that should be ascertained or excluded from a clinical point of view.
There are various organic causes, such as a narrowing of the intestinal lumen of the inflammatory origin or, more rarely, a tumor form that can make the material of this consistency difficult to evacuate. In these situations, it is advisable to undergo an accurate visit to the gastroenterologist and perform a colonoscopy.
If no organic problem is found during the diagnostic process, the condition may be associated with impaired intestinal transit or difficulty with rectal expulsion .
Medicines: which can promote hard stools?
Less often, at the origin of hard stools, there is the intake of certain drugs that are able to reduce the motility of the intestine . Consequently, in those predisposed to constipation, these medicines facilitate the onset of the problem.
These drugs include:
- Anxiolytics, sleeping pills, and antidepressants ;
- Calcium channel blockers (medicines used to control blood pressure);
- Painkillers based opioids (medications you are taking for chronic pain);
What diseases can be associated with hard stools?
As anticipated, hard stools are associated, in most cases, with constipation (constipation) .
This symptom may depend on:
- Dysfunction of the muscles of the pelvic floor ;
- Hormonal changes during pregnancy, before the menstrual cycle and in menopause;
- Structural alterations of the intestine, such as, for example, in the case of post-inflammatory stenosis in Crohn’s disease or post-operative scarring results;
- Reduced colon motility.
Pathologies that can be associated with the problem include:
- Irritable bowel syndrome;
- Colon cancer or other abdominal organs ;
- Intestinal polyps ;
- Hypothyroidism ;
- Systemic lupus erythematosus ;
- Multiple sclerosis ;
- Hemorrhoids ;
- Stroke ;
- Parkinson’s disease ;
- Trauma or tumors of the spine.
Symptoms and Complications
Hard stools are manifested by the evident alteration of the consistency of the manure , which is dry and scarce . Consequently, the passage of the material is infrequent or difficult.
Depending on the triggering cause, this symptom can appear as a sporadic (associated with a single episode), continuous or recurrent manifestation (it is necessary until the underlying pathology is resolved).
Hard stools: how do they manifest?
Hard and dry stools are very difficult to expel and their evacuation can be associated with:
- Pain due to the formation of traumatic lesions at the level of the anal walls;
- Feeling of incomplete evacuation ;
- Heaviness and abdominal swelling .
Frequent complications of hard stools are anal fissures and hemorrhoids .
Possible associated disorders
Hard stools can be associated with other symptoms affecting the intestine and digestive tract, usually depending on the causes that provoked the manifestation under examination.
Among the disorders most commonly associated with hard stools you can find:
- Pain or abdominal cramps ;
- Excessive flatulence or frequent belching ;
- Relaxed abdomen and sense of fullness;
- Absence of stool evacuation for at least three consecutive days;
- Nausea and vomiting ;
- Loss of appetite.
Diagnosing the causes of hard stools begins with a thorough clinical evaluation.
Behind this symptom, in fact, even important problems can be hidden. For this, it becomes of fundamental importance to act with a timely and, of course, correct diagnosis.
Did you know that…
The color, consistency and shape of the stool reveal information on the condition of the organism and on the correct functioning of the digestive system . For this reason, it is advisable to check faecal waste daily.
Hard stools: when should I go to the doctor?
- When hard stool occurs sporadically or is linked to an already diagnosed constipation condition, an emergency consultation is not necessary. In these cases, however, it is useful to communicate the episode to your doctor or referral gastroenterologist, to receive advice on how to behave according to the medical history known to the clinician.
- The evaluation of the doctor is appropriate, however, in the following cases:
- Hard stools are not episodic, but repeat frequently or persist for over three weeks;
- Hard stools are severely manifested or accompanied by:
- Abdominal pain acute;
- Unusual changes in intestinal activities (e.g. constipation alternating with diarrhea );
- Fever ;
- Pain in the rectal area;
- Unexplained and sudden weight loss ;
- Hard stools are ribbon-shaped, that is, they take on a thin and elongated appearance.
- It is necessary to consult a doctor promptly even in the presence of:
What tests are indicated for hard stools?
The diagnostic procedure to ascertain the causes of hard stools involves, first of all, the anamnesis (or the review of the anamnesis information if constipation is known to the doctor) and the physical examination of the patient with rectal exploration.
The doctor may ask to carry out further investigations, which may include both the examination of the stool itself and the analysis of blood and urine, including the blood count, the liver function test, and the dosage of pancreatic enzymes.
As for laboratory analyzes, chemical-physical and cultural tests of the fecal material are useful. The search for occult blood in hard stools can be performed, however, to search for any blood loss from the gastrointestinal tract.
To establish the causes responsible for hard stools, depending on the suspected cause, the doctor can also indicate the execution of more targeted diagnostic investigations, such as:
- Esophagogastroduodenoscopy (EGDS): endoscopic examination that allows you to visualize the inside of the esophagus, stomach, and duodenum ;
- Colonoscopy: allows to examine the inside of the colon, identifying polyps or cancerous lesions;
- CT or MRI: useful imaging studies to highlight some neoplastic lesions.
If the doctor suspects that constipation is linked to intestinal dysfunction, the doctor may indicate that:
- Anorectal manometry;
- Study of colon transit times;
- Defecography .
Treatment and Remedies
Hard stool treatment varies depending on the underlying disease.
In many cases, these are absolutely temporary ailments , destined to be resolved without the need for specific therapies. At other times, hard stools may require targeted treatments for their solution.
If constipation (constipation) or poor bowel activity is the root cause of hard stools, it is necessary to intervene on lifestyle and eating habits , drinking greater quantities of liquids and taking more fiber in the form of fruit, vegetables and whole grains.
Fibers are useful because they make the stool softer and more voluminous, promote the stimulation of defecation, and accelerate intestinal motility.
To counteract the problem of hard stools, it is also useful to move as much as possible : sometimes, just practicing a light, but constant physical activity helps the intestine to work more regularly.
Only in the most stubborn cases of hard stool, the doctor can decide to prescribe laxatives or prokinetic drugs to stimulate or accelerate the evacuation. These products should be taken only after a careful evaluation, since, if there was a mechanical obstruction (secondary, for example, to chronic inflammation of the diverticula, tumor, etc.), they could cause intestinal obstruction with very serious consequences.
In some cases, especially in those suffering from chronic constipation, it is possible to indicate:
- Suppositories based on glycerin;
- Mass-forming laxatives, based on fibers such as psyllium and methylcellulose, which act by making the stool softer and consequently facilitating evacuation;
- Laxatives type osmotic (saline or not), such as preparations of polyethylene glycol, which act by increasing the volume of stool;
- Senna- based stimulating laxatives that work by increasing intestinal motility;
- Medicines such as linaclotide and prucalopride;
- Re-education of the pelvic floor muscles.
If hard stool depends on other diseases, it is necessary, first of all, to intervene on these causes with targeted treatments.
Hard stools: WHAT TO DO
- Increase the consumption of high fiber foods such as:
- Eat small quantities of everything, including fats such as olive oil, yogurt, and dairy products in general so as to keep the intestinal flora in balance, promote its efficiency and, consequently, the correct evacuation;
- Increase the water intake throughout the day to prevent dehydration and stimulate the motility of the intestine, soften the stool, and facilitate its expulsion. In the case of hard stools, fruit juices and the morning intake of warm or lukewarm drinks are particularly recommended;
- Chew the food slowly and for a long time in order to favor the production of saliva, which helps the breakdown of food and, therefore, the formation of feces;
- Take laxatives only according to medical prescription;
- Practicing physical activity because it helps the intestine to work more regularly.
Hard stool: WHAT TO AVOID
- Don’t try too hard when defecating;
- Do not take foods with astringent action, such as lemon, tea, cocoa, blackberries, blueberries, prickly pears, and black currants ;
- Do not over consume foods that promote constipation such as potatoes, rice, bananas, and carrots ;
- Do not use laxatives without a doctor’s prescription: these products must always be taken under medical supervision and for short periods.