Hard Stool: Soften And Evacuate

Constipation is a common issue that can be uncomfortable and frustrating. It is characterised by fewer than three bowel movements per week and hard, dry, and small stools that are difficult and sometimes painful to pass. The main causes of constipation are irritable bowel syndrome and chronic constipation, which can be the result of a slower movement of food through the intestines, allowing for more water absorption and leading to harder stools. Treatment options include dietary changes, such as increasing fibre intake and staying hydrated, as well as over-the-counter stool softeners and prescription medications in some cases.

How to Eliminate Hard Stools

Drink more water

Drinking more water is one of the most effective ways to prevent and treat hard stools. Water is essential for healthy digestion, as it helps to break down food and move it through the intestines. When the body is dehydrated, the colon absorbs too much water from the stool, resulting in hard, dry stools that are difficult to pass.

The large intestine, or colon, is responsible for absorbing water from food during digestion. If food moves too slowly through the colon, it will absorb more water from the stool, leading to constipation. Staying properly hydrated ensures that there is enough water in the digestive tract to soften the stool and facilitate its passage.

The amount of water needed varies from person to person and depends on factors such as age, gender, activity level, and climate. A general rule to determine if you are getting enough water is to look at the colour of your urine. If it is dark yellow and you are urinating infrequently, it is likely that your body is dehydrated. Aiming for a pale yellow colour is a good indication that you are adequately hydrated.

In addition to increasing water intake, it is important to make sure you are consuming enough fibre, as this helps promote the movement of food through the digestive tract and adds bulk to the stool. However, it is important to increase fibre intake gradually, as adding too much fibre too quickly can cause digestive discomfort.

For those who find it challenging to drink enough water, prune juice is a good alternative, as it helps to soften stools. Drinking a glass of warm water in the morning can also be beneficial.

Eat more fibre-rich foods

Eating more fibre-rich foods is a great way to help with hard stools. Fibre-rich foods can prevent or relieve constipation, which is often the cause of hard stools. Fibre-rich foods are plant-based and include fruits, vegetables, grains, nuts, seeds, and legumes.

Fibre exists in two forms: soluble and insoluble. Soluble fibre partially dissolves in water, creating a gel-like substance that helps lower cholesterol. Sources of soluble fibre include oats, barley, rye, beans, oranges, and apples. Insoluble fibre remains more intact as it passes through the digestive system, adding bulk to stools and making them easier to pass. Insoluble fibre may also aid weight loss by creating a sense of fullness without adding calories. Sources of insoluble fibre include wheat, brown rice, celery, carrots, nuts, and seeds. Many foods contain both types of fibre.

To relieve constipation, it is recommended to consume whole-grain breads, cereals, and pastas. Cereal fibres generally have cell walls that resist digestion and retain water within their structures. Wheat bran, in particular, can be highly effective as a natural laxative.

Citrus fruits and legumes are also great fibre-rich foods to eat as they stimulate the growth of colonic flora, increasing stool weight and the amount of bacteria in the stool. Encouraging the growth of certain bacteria in the colon may promote a healthy intestine.

According to the USDA’s Dietary Guidelines for Americans, 2020-2025, it is recommended that women under 51 should aim for 25 grams of fibre daily, while men under 51 should aim for 38 grams. Women 51 and older should aim for 21 grams, and men 51 and older should aim for 30 grams.

It is important to note that some people experience stomach cramps and gas when they increase their fibre intake. To reduce discomfort, it is recommended to change your diet gradually and increase fluid intake.

Exercise regularly

Exercising regularly is a great way to keep your digestive system healthy and active, and can help prevent constipation. The National Institutes of Health (NIH) recommends getting about 20 to 30 minutes of exercise at least three times per week to help prevent constipation.

Yoga is a great way to relieve constipation. Certain poses increase blood flow to the digestive tract and stimulate the intestines to contract, making digestion more efficient. For example, the Hero's pose (Virasana) is done by kneeling on the ground with your knees apart and feet together. Slowly sink your hips down until they are resting between your feet, keeping your back straight. Another pose that might help is the Wind-Releasing pose (Pavanmuktasana). Lie on your back, bring both knees up to your chest, and gently add pressure, bringing your thighs into your belly.

Walking and swimming for 20 to 30 minutes can also help relieve constipation.

Try laxatives

If dietary and lifestyle changes do not help with hard stools, over-the-counter laxatives can be used to help treat constipation. Laxatives should not be the first port of call, but they can be used if you have already tried increasing your fibre and water intake without success.

Laxatives come in several forms, and it is important to consult a doctor to determine which type is best for you, how long you should take them for, and how to ease off them when you no longer need them. Laxatives are best taken short-term, as you do not want to become reliant on them to go to the toilet.

Bulk-forming fibre supplements include calcium polycarbophil, methylcellulose fibre, psyllium, and wheat dextrin. These supplements can be taken daily and are safe to use regularly. They work by making the stool bigger and softer. However, they can cause bloating, cramps, and gas, and may interfere with your body's ability to absorb certain medications. It is important to drink plenty of water when taking these supplements.

Lubricant laxatives, such as Zymenol, help the stool pass more easily through the colon. Doctors generally do not recommend using mineral oil or castor oil, as these can cause problems such as vitamin deficiencies and long-term constipation, respectively.

Osmotic laxatives, such as lactitol, lactulose, magnesium hydroxide, polyethylene glycol, and sorbitol, help fluids move through your intestines. If you have diabetes, consult your doctor before taking these, as they can cause electrolyte imbalances.

Stimulant laxatives, such as bisacodyl and sennosides, make the muscles in your intestines contract to help push the stool out. These laxatives work quickly but can cause side effects such as cramping and diarrhoea, so they should be used for as short a time as possible.

Stool softeners, such as docusate calcium and docusate sodium, make stools easier to pass by adding fluid to them. Softer stools can prevent you from having to strain during bowel movements.

Adjust toilet posture

Adjusting your toilet posture can make it easier to pass hard stools. The following are some suggested toilet postures that may help:

Squatting

Squatting is a natural position for defecation and can help relax the muscles and open the gut, allowing for easier passage of stool. To squat on a standard toilet, you can use a toilet squat stool, which helps readjust your body position. Place the stool in front of the toilet, and rest your feet on it while leaning your torso slightly forward. This will help you achieve a more squatted position, which may make it easier to pass hard stools.

Raising your legs

Another option is to try raising your legs while sitting on the toilet. You can do this by placing a small step stool or similar object under your feet, so that your knees are raised above your hips. This position may help relax the muscles and facilitate easier passage of stool.

Leaning back

Leaning back while seated on the toilet can also help with constipation. This position can help straighten the rectum, making it easier for the stool to pass.

It is important to remember that everyone's body is different, and you may need to experiment with different postures to find what works best for you. These adjustments may help make it easier to pass hard stools, but they should be used in conjunction with other methods, such as increasing your fibre and water intake, as recommended by medical professionals.

Frequently asked questions