Hard Stool

Medically Reviewed By William C. Lloyd III, MD, FACS
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What is hard stool?

Hard stool—or hard poop—is a symptom of constipation. Constipation is a condition in which stool moves too slowly through the large intestine. One of the large intestine’s main job is to absorb water. In fact, it absorbs about 1 to 1.5 liters of water every day. The result should be solid stool that is easy to pass.

The normal frequency of passing stool varies anywhere from several times a day to only a few times per week. Being regular has less to do with how often you pass stool and more to do with the consistency and ease of having a bowel movement. Similarly, constipation is more about difficulty passing hard stool than it is about how often you have a bowel movement.

Hard stool is the result of the large intestine absorbing too much water. When constipation extends the time stool spends in the large intestine, there is a longer opportunity to take water out of it. There can be several underlying causes for being constipated with hard stool. This includes not eating enough fiber, not drinking enough fluids, and not responding to the urge to move your bowels. Many medications, including opioids, delay the normal digestive process and stool elimination.

Other symptoms may accompany hard stool, including bloating, straining, pain with bowel movements, and feeling like your bowel movement is incomplete. Having hard stool causes small tears and hemorrhoids, in some cases. This can result in passing hard stool with blood.

Constipation with hard stool is a very common condition. About 4 million Americans deal with recurrent constipation. It becomes more likely as you age and is more of an issue in women compared to men.

Constipation and hard stool remedies include eating more fiber, drinking plenty of fluids, exercising regularly, and responding as soon as possible to urges to have a bowel movement. If these lifestyle habits don’t solve your constipation issue, your doctor may recommend medicines, such as stool softeners or laxatives. When there is a structural problem or blockage, surgery may be an option.

Left untreated, frequent constipation and hard stools can lead to impaction and rectal prolapse. If you have persistent constipation or hard stool with blood, see your doctor promptly. Sometimes, chronic constipation can be a sign of an underlying medical condition.

What are the symptoms of hard stool?

Hard, lumpy, dry stool is a symptom of constipation. Symptoms of constipation are the result of stool taking an extended transit time to pass through the large intestine. This allows the large intestine to absorb too much water and increases pressure in the bowel.

Common symptoms of constipation with hard stool

Other symptoms that commonly occur with hard stool include:

Symptoms that might indicate a serious condition

In some cases, hard stool can be a sign of something more serious than everyday constipation. Seek prompt medical care if you have these potentially serious symptoms:

Make an appointment with your doctor if you have constipation that lasts for more than two weeks despite home treatments.

What causes hard stool?

Hard stool is the result of too much water being absorbed in the large intestine—or colon. This effect is the result of constipation, in which stool passes too slowly through the colon. Common causes of constipation include:

  • Ignoring urges to have a bowel movement, which is a common cause in children
  • Lack of fiber in the diet
  • Medications, such as narcotics, antidepressants, iron supplements, and muscle relaxants
  • Poor fluid intake
  • Schedule interruptions, such as travel and stress
  • Sedentary lifestyle

According to the American Academy of Pediatrics, young infants rarely have a problem with constipation. However, the transition to solid food can be a trigger for hard stool.

Sometimes, constipation and hard stool can be a sign of an underlying medical condition. This includes:

  • Blockages, including tumors, cancer, bowel stricture (narrowing), and rectocele (bulging of the rectum into the vagina)

What are the risk factors for hard stool?

A number of factors increase the risk of developing constipation with hard stool. Risk factors include:

  • Aging
  • Being a woman
  • Being dehydrated
  • Being sedentary
  • Eating a diet without enough fiber
  • Taking medications that can lead to constipation

Reducing your risk of hard stool

There are steps you can take to lower your risk of constipation with hard stool including:

  • Drinking plenty of fluids throughout the day
  • Eating a high-fiber diet. The best food for hard stool includes fresh fruits and vegetables, whole-grain breads and cereals, and beans and legumes
  • Getting regular physical exercise on most days of the week
  • Not ignoring the urge to have a bowel movement

Discuss any changes in bowel habits with your doctor. Find out if you have risk factors for constipation and hard stool and how to manage them.

How is hard stool treated?

Constipation and hard stool treatment starts with the same strategies for preventing constipation. When making dietary changes, it’s best to start by adding high-fiber foods to one meal at a time. Adding too much fiber all at once can lead to gas, discomfort and bloating. For babies, doctors may recommend simply increasing the amount of water or juice they drink.

If lifestyle habits alone aren’t enough to improve hard stool, your doctor may suggest over-the-counter products including:

  • Fiber supplements
  • Mineral oil
  • Stimulant or osmotic laxatives
  • Stool softeners
  • Suppositories

When an underlying medical condition is causing constipation and hard stool, treating it should help relieve the problem. For IBS patients and opioid users, there are medications your doctor may prescribe to help get your bowel back on track. If there is a structural problem with the bowel or a bowel blockage, surgery may be necessary.

What are the potential complications of hard stool?

Ongoing constipation with hard stool can lead to several complications including:

  • Anal fissures, which are tears in the anus
  • Encopresis, which is leakage of liquid stool around an impaction
  • Impaction, which is an accumulation of hard stool that you can’t pass without manual removal followed by enemas
  • Rectal prolapse, which is a bulging of the rectum out through the anus
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 4
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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