Hard stool happens when your colon absorbs too much water from your stool. This commonly occurs withconstipation, defined as having fewer than three bowel movements per week. Common causes includedehydrationand alow-fiber diet. If constipation and hard stools persist for more than three months, it is known aschronic constipation.
Hard stools can often be treated or prevented with simple lifestyle adjustments, like eating more fiber and drinking more fluids. In severe cases, medications, enemas, specialist procedures, and even surgery may be needed.
Verywell / Nusha Ashjaee
Causes
Stools become hard when they don’t contain enough water. This can happen if takes too long for stool to travel through yourlarge intestine(called the stool transit time).
Common causes for this include:
Certain gastrointestinal, neurologic, metabolic, and even psychiatric conditions are associated with chronic constipation, including:
Treatment
If conservative self-care treatments fail to provide relief, speak with your healthcare provider or seek a referral to a specialist called agastroenterologistwho can evaluate you and recommend a treatment plan.
Lifestyle Changes
As diet, dehydration, and a sedentary lifestyle are prime risk factors for hard stools and constipation, the frontline approach commonly involves lifestyle changes to address these concerns.
These involve simple modifications like:
Medications
Certain medications, both prescription and over-the-counter (OTC), can treat constipation in different ways. Many are intended for short-term relief and may be habit-forming, so speak with your provider to ensure that you are treating constipation appropriately.
These include OTC products like:
Prescription drugs used to treat constipation include:
Specialist Procedures
In addition to lifestyle changes and medications, specialist procedures may be needed if you experiencefecal impaction. This occurs when hard stool “piles up” in the bowel and becomes increasingly difficult to move. Left untreated, this can cause bleeding, hemorrhoids, andbowel obstruction.
Option include:
Complementary and Alternative Therapy
Some people prefer a more natural approach to treating hard stools and will turn to complementary and alternative therapies that do not involve drugs.
Some healthcare providers recommendprobioticsfor constipation, but a 2020 review of studies found insufficient evidence of any real benefit.The current research supporting the use of acupuncture and acupressure in treating constipation is also poor and inconsistent.
Experts warn against using natural products marketed as laxatives (such as Chinese herbs) due to concerns about purity. They can also interact with other medications you may be taking.
Surgery
Your gastroenterologist may recommend surgery if you have a severe bowel obstruction due tointestinal stricture(narrowing of the intestine) orrectal prolapse(bulging of the large intestine into the anus).
Examples include:
Prevention
Hard stools can often be prevented with simple remedies like changing what you eat and drink. Most people can successfully prevent constipation at home, but if the problem persists, see your healthcare provider.
To better help prevent constipation and hard stool:
Summary
Hard stools occur because your colon absorbs too much water from stool, leading to constipation. This can happen if you are dehydrated and lack fiber in your diet. It can also occur if you put off having a bowel movement.
Treatment of hard stools includes increased hydration, exercise, and eating more soluble fiber. If needed, you can turn to over-the-counter laxatives and stool softeners as well as prescription drugs for specific types of constipation. In severe cases, an enema, digital disimpaction, or surgery may be needed.
21 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bharucha AE, Lacy BE.Mechanisms, evaluation, and management of chronic constipation.Gastroenterology. 2020;158(5):1232-1249.e3. doi:10.1053/j.gastro.2019.12.034Johns Hopkins Medicine.Constipation.Heidelbaugh J, de Andino NM,Pineles D, Poppers DM.Diagnosing constipation spectrum disorders in a primary care setting.J Clin Med. 2021 Mar 5;10(5):1092. doi:10.3390/jcm10051092National Academies of Science, Engineering and Medicine.Report sets dietary intake levels for water, salt, and potassium to maintain health and reduce chronic disease risk.Gao R, Tao Y, Zhou C, et al.Exercise therapy in patients with constipation: a systematic review and meta-analysis of randomized controlled trials.Scand J Gastroenterol. 2019 Feb;54(2):169-177. doi:10.1080/00365521.2019.1568544International Foundation for Gastrointestinal Disorders.Bowel retraining: strategies for establishing control.Jin J.Over-the-counter laxatives.JAMA.2014;312(11):1167. doi:10.1001/jama.2014.2078Wald A.Treating constipation with medications.JAMA.2016;315(12):1299. doi:10.1001/jama.2015.17993Serrano Falcón B, Barceló López M, Mateos Muñoz B, Álvarez Sánchez A, Rey E.Fecal impaction: a systematic review of its medical complications.BMC Geriatr. 2016;16:4. doi:10.1186/s12877-015-0162-5Canadian Society of Intestinal Research.Enemas.Rao SS, Patcharatrakul T.Diagnosis and treatment of dyssynergic defecation.J Neurogastroenterol Motil. 2016 Jul 30;22(3):423-35. doi:10.5056/jnm16060Mcclurg D, Walker K, Jamieson K, et al.Abdominal massage for the relief of constipation in people with Parkinson’s: A qualitative study.Parkinsons Dis.2016;2016:4842090. doi:10.1155/2016/4842090Chiarioni G.Biofeedback treatment of chronic constipation: myths and misconceptions.Tech Coloproctol. 2016;20(9):611-8. doi:10.1007/s10151-016-1507-6Kamiński M, Skonieczna-Żydecka K, Łoniewski I, Koulaouzidis A, Marlicz W.Are probiotics useful in the treatment of chronic idiopathic constipation in adults? A review of existing systematic reviews, meta-analyses, and recommendations.Prz Gastroenterol.2020;15(2):103-118. doi:10.5114/pg.2019.86747Jiang ZF, Liu G, Sun XX, et al.Auricular acupressure for constipation in adults: a systematic review and meta-analysis.Front Physiol. 2023;12:2023. doi:10.3389/fphys.2023.1257660National Institute of Complementary and Integrative Health.Traditional Chinese medicine: what you need to know.National Institute of Diabetes and Digestive and Kidney Diseases.Treatment for constipation.You H, Sweeny A, Cooper ML, et al.The management of diverticulitis: a review of the guidelines.Med J Austral.2019;211(9):421-427. doi:10.5694/mja2.50276Alam NN, Narang SK, Kockerling F, Daniels IR, Smart NJ.Rectopexy for rectal prolapse.Front Surg. 2015 Oct 19;2:54. doi:10.3389/fsurg.2015.00054Senia MC, Dharmasena S, Capps O.Can dietary fiber intake be increased through nutritional education and through subsidies on selected food products?Agric Resour Econ Rev. 2019;48(3):448-72. doi:10.1017/age.2019.29Yang H, Ma T.Luminally acting agents for constipation treatment: a review based on literatures and patents.Front Pharmacol.2017;8:418. doi:10.3389/fphar.2017.00418
21 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bharucha AE, Lacy BE.Mechanisms, evaluation, and management of chronic constipation.Gastroenterology. 2020;158(5):1232-1249.e3. doi:10.1053/j.gastro.2019.12.034Johns Hopkins Medicine.Constipation.Heidelbaugh J, de Andino NM,Pineles D, Poppers DM.Diagnosing constipation spectrum disorders in a primary care setting.J Clin Med. 2021 Mar 5;10(5):1092. doi:10.3390/jcm10051092National Academies of Science, Engineering and Medicine.Report sets dietary intake levels for water, salt, and potassium to maintain health and reduce chronic disease risk.Gao R, Tao Y, Zhou C, et al.Exercise therapy in patients with constipation: a systematic review and meta-analysis of randomized controlled trials.Scand J Gastroenterol. 2019 Feb;54(2):169-177. doi:10.1080/00365521.2019.1568544International Foundation for Gastrointestinal Disorders.Bowel retraining: strategies for establishing control.Jin J.Over-the-counter laxatives.JAMA.2014;312(11):1167. doi:10.1001/jama.2014.2078Wald A.Treating constipation with medications.JAMA.2016;315(12):1299. doi:10.1001/jama.2015.17993Serrano Falcón B, Barceló López M, Mateos Muñoz B, Álvarez Sánchez A, Rey E.Fecal impaction: a systematic review of its medical complications.BMC Geriatr. 2016;16:4. doi:10.1186/s12877-015-0162-5Canadian Society of Intestinal Research.Enemas.Rao SS, Patcharatrakul T.Diagnosis and treatment of dyssynergic defecation.J Neurogastroenterol Motil. 2016 Jul 30;22(3):423-35. doi:10.5056/jnm16060Mcclurg D, Walker K, Jamieson K, et al.Abdominal massage for the relief of constipation in people with Parkinson’s: A qualitative study.Parkinsons Dis.2016;2016:4842090. doi:10.1155/2016/4842090Chiarioni G.Biofeedback treatment of chronic constipation: myths and misconceptions.Tech Coloproctol. 2016;20(9):611-8. doi:10.1007/s10151-016-1507-6Kamiński M, Skonieczna-Żydecka K, Łoniewski I, Koulaouzidis A, Marlicz W.Are probiotics useful in the treatment of chronic idiopathic constipation in adults? A review of existing systematic reviews, meta-analyses, and recommendations.Prz Gastroenterol.2020;15(2):103-118. doi:10.5114/pg.2019.86747Jiang ZF, Liu G, Sun XX, et al.Auricular acupressure for constipation in adults: a systematic review and meta-analysis.Front Physiol. 2023;12:2023. doi:10.3389/fphys.2023.1257660National Institute of Complementary and Integrative Health.Traditional Chinese medicine: what you need to know.National Institute of Diabetes and Digestive and Kidney Diseases.Treatment for constipation.You H, Sweeny A, Cooper ML, et al.The management of diverticulitis: a review of the guidelines.Med J Austral.2019;211(9):421-427. doi:10.5694/mja2.50276Alam NN, Narang SK, Kockerling F, Daniels IR, Smart NJ.Rectopexy for rectal prolapse.Front Surg. 2015 Oct 19;2:54. doi:10.3389/fsurg.2015.00054Senia MC, Dharmasena S, Capps O.Can dietary fiber intake be increased through nutritional education and through subsidies on selected food products?Agric Resour Econ Rev. 2019;48(3):448-72. doi:10.1017/age.2019.29Yang H, Ma T.Luminally acting agents for constipation treatment: a review based on literatures and patents.Front Pharmacol.2017;8:418. doi:10.3389/fphar.2017.00418
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Bharucha AE, Lacy BE.Mechanisms, evaluation, and management of chronic constipation.Gastroenterology. 2020;158(5):1232-1249.e3. doi:10.1053/j.gastro.2019.12.034Johns Hopkins Medicine.Constipation.Heidelbaugh J, de Andino NM,Pineles D, Poppers DM.Diagnosing constipation spectrum disorders in a primary care setting.J Clin Med. 2021 Mar 5;10(5):1092. doi:10.3390/jcm10051092National Academies of Science, Engineering and Medicine.Report sets dietary intake levels for water, salt, and potassium to maintain health and reduce chronic disease risk.Gao R, Tao Y, Zhou C, et al.Exercise therapy in patients with constipation: a systematic review and meta-analysis of randomized controlled trials.Scand J Gastroenterol. 2019 Feb;54(2):169-177. doi:10.1080/00365521.2019.1568544International Foundation for Gastrointestinal Disorders.Bowel retraining: strategies for establishing control.Jin J.Over-the-counter laxatives.JAMA.2014;312(11):1167. doi:10.1001/jama.2014.2078Wald A.Treating constipation with medications.JAMA.2016;315(12):1299. doi:10.1001/jama.2015.17993Serrano Falcón B, Barceló López M, Mateos Muñoz B, Álvarez Sánchez A, Rey E.Fecal impaction: a systematic review of its medical complications.BMC Geriatr. 2016;16:4. doi:10.1186/s12877-015-0162-5Canadian Society of Intestinal Research.Enemas.Rao SS, Patcharatrakul T.Diagnosis and treatment of dyssynergic defecation.J Neurogastroenterol Motil. 2016 Jul 30;22(3):423-35. doi:10.5056/jnm16060Mcclurg D, Walker K, Jamieson K, et al.Abdominal massage for the relief of constipation in people with Parkinson’s: A qualitative study.Parkinsons Dis.2016;2016:4842090. doi:10.1155/2016/4842090Chiarioni G.Biofeedback treatment of chronic constipation: myths and misconceptions.Tech Coloproctol. 2016;20(9):611-8. doi:10.1007/s10151-016-1507-6Kamiński M, Skonieczna-Żydecka K, Łoniewski I, Koulaouzidis A, Marlicz W.Are probiotics useful in the treatment of chronic idiopathic constipation in adults? A review of existing systematic reviews, meta-analyses, and recommendations.Prz Gastroenterol.2020;15(2):103-118. doi:10.5114/pg.2019.86747Jiang ZF, Liu G, Sun XX, et al.Auricular acupressure for constipation in adults: a systematic review and meta-analysis.Front Physiol. 2023;12:2023. doi:10.3389/fphys.2023.1257660National Institute of Complementary and Integrative Health.Traditional Chinese medicine: what you need to know.National Institute of Diabetes and Digestive and Kidney Diseases.Treatment for constipation.You H, Sweeny A, Cooper ML, et al.The management of diverticulitis: a review of the guidelines.Med J Austral.2019;211(9):421-427. doi:10.5694/mja2.50276Alam NN, Narang SK, Kockerling F, Daniels IR, Smart NJ.Rectopexy for rectal prolapse.Front Surg. 2015 Oct 19;2:54. doi:10.3389/fsurg.2015.00054Senia MC, Dharmasena S, Capps O.Can dietary fiber intake be increased through nutritional education and through subsidies on selected food products?Agric Resour Econ Rev. 2019;48(3):448-72. doi:10.1017/age.2019.29Yang H, Ma T.Luminally acting agents for constipation treatment: a review based on literatures and patents.Front Pharmacol.2017;8:418. doi:10.3389/fphar.2017.00418
Bharucha AE, Lacy BE.Mechanisms, evaluation, and management of chronic constipation.Gastroenterology. 2020;158(5):1232-1249.e3. doi:10.1053/j.gastro.2019.12.034
Johns Hopkins Medicine.Constipation.
Heidelbaugh J, de Andino NM,Pineles D, Poppers DM.Diagnosing constipation spectrum disorders in a primary care setting.J Clin Med. 2021 Mar 5;10(5):1092. doi:10.3390/jcm10051092
National Academies of Science, Engineering and Medicine.Report sets dietary intake levels for water, salt, and potassium to maintain health and reduce chronic disease risk.
Gao R, Tao Y, Zhou C, et al.Exercise therapy in patients with constipation: a systematic review and meta-analysis of randomized controlled trials.Scand J Gastroenterol. 2019 Feb;54(2):169-177. doi:10.1080/00365521.2019.1568544
International Foundation for Gastrointestinal Disorders.Bowel retraining: strategies for establishing control.
Jin J.Over-the-counter laxatives.JAMA.2014;312(11):1167. doi:10.1001/jama.2014.2078
Wald A.Treating constipation with medications.JAMA.2016;315(12):1299. doi:10.1001/jama.2015.17993
Serrano Falcón B, Barceló López M, Mateos Muñoz B, Álvarez Sánchez A, Rey E.Fecal impaction: a systematic review of its medical complications.BMC Geriatr. 2016;16:4. doi:10.1186/s12877-015-0162-5
Canadian Society of Intestinal Research.Enemas.
Rao SS, Patcharatrakul T.Diagnosis and treatment of dyssynergic defecation.J Neurogastroenterol Motil. 2016 Jul 30;22(3):423-35. doi:10.5056/jnm16060
Mcclurg D, Walker K, Jamieson K, et al.Abdominal massage for the relief of constipation in people with Parkinson’s: A qualitative study.Parkinsons Dis.2016;2016:4842090. doi:10.1155/2016/4842090
Chiarioni G.Biofeedback treatment of chronic constipation: myths and misconceptions.Tech Coloproctol. 2016;20(9):611-8. doi:10.1007/s10151-016-1507-6
Kamiński M, Skonieczna-Żydecka K, Łoniewski I, Koulaouzidis A, Marlicz W.Are probiotics useful in the treatment of chronic idiopathic constipation in adults? A review of existing systematic reviews, meta-analyses, and recommendations.Prz Gastroenterol.2020;15(2):103-118. doi:10.5114/pg.2019.86747
Jiang ZF, Liu G, Sun XX, et al.Auricular acupressure for constipation in adults: a systematic review and meta-analysis.Front Physiol. 2023;12:2023. doi:10.3389/fphys.2023.1257660
National Institute of Complementary and Integrative Health.Traditional Chinese medicine: what you need to know.
National Institute of Diabetes and Digestive and Kidney Diseases.Treatment for constipation.
You H, Sweeny A, Cooper ML, et al.The management of diverticulitis: a review of the guidelines.Med J Austral.2019;211(9):421-427. doi:10.5694/mja2.50276
Alam NN, Narang SK, Kockerling F, Daniels IR, Smart NJ.Rectopexy for rectal prolapse.Front Surg. 2015 Oct 19;2:54. doi:10.3389/fsurg.2015.00054
Senia MC, Dharmasena S, Capps O.Can dietary fiber intake be increased through nutritional education and through subsidies on selected food products?Agric Resour Econ Rev. 2019;48(3):448-72. doi:10.1017/age.2019.29
Yang H, Ma T.Luminally acting agents for constipation treatment: a review based on literatures and patents.Front Pharmacol.2017;8:418. doi:10.3389/fphar.2017.00418
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