Soften Hard Stools

Passing hard, dry stool is painful. It hurts when it blocks your bowels and when it is difficult to pass. There are several dietary and lifestyle changes that will likely help solve the problem. If they don’t work, see a doctor to get something stronger.

Steps

Softening Stool through Diet

1. Drink more water. Dehydration can cause your body to extract as much water as it can as foods move through your digestive tract, producing dry, hard stool. Drinking enough water will soften your stool and help things move along more easily.
   • Doctors sometimes recommend about two liters, or 8 glasses, of water per day. However, that may not be enough for you, depending on your activity level and the climate you live in.
   • If you have frequent headaches, fatigue, dizziness, nausea, don’t urinate often, pass dark or cloudy urine, and don’t sweat much, you are probably not getting enough water.
2. Eat foods that have slight laxative effects and are high in fiber. Some of these, like prunes, have sorbitol. Sorbitol draws water into the stool, making it soft and easy to pass.
   • Prunes or prune juice
   • Peaches
   • Pears
   • Plums
   • Apples
   • Apricots
   • Raspberries
   • Strawberries
   • Beans
   • Peas
   • Spinach
3. Eat more fiber. Fiber is the indigestible material in plant foods. Your body passes them through without absorbing them. This means that they help to produce soft, bulky stool which is easy to pass.
   • Most people don’t eat the entire recommended amount of fiber each day, which is {{safesubst:#invoke:convert|convert}}. You need both water soluble fiber, which turns into a gel-like material in water, and insoluble fiber, which does not dissolve.
   • Soluble fiber is found in oats, peas, beans, apples, citrus fruits, carrots, and barley.
   • You can get insoluble fiber in whole-wheat flour, wheat bran, nuts, beans, and vegetables like cauliflower and green beans.
   • Many plants have both soluble and insoluble fiber, you can get both by eating lots of different grains and vegetables.
   • Eating more fiber will be most effective if you drink extra water to help dissolve the water soluble fiber.
4. Maintain healthy gut bacteria by eating yogurt. Your digestive tract needs the right balance of microbes to efficiently digest your food. When this microbe community gets out of balance, it can make you constipated and interfere with the absorption of nutrients. Live culture yogurt and other fermented dairy products like kefir can help restore and rebalance your gut bacteria. This can help you combat hard stools due to:
   • Irritable bowel syndrome
   • Unexplained diarrhea and constipation
   • Diarrhea or constipation after antibiotics have killed some of the naturally occurring gut bacteria
5. Add supplements to your diet to promote healthy digestion. But be sure to consult your doctor first because some supplements may change how your body processes some medicines.
   • Try fiber supplements. They will make your stool bulkier, softer and easier to pass. These supplements are often called bulk forming laxatives and you should try these before moving on to other types of laxatives. Look for ones with methylcellulose, psyllium, calcium polycarbophil, and guar gum as active ingredients (e.g., FiberCon, Metamucil, Konsyl, and Citrucel).
   • Try probiotic supplements. Probiotics are bacteria and yeasts that are like your naturally occurring gut microbes. Taking probiotics may help if you are experiencing cycles of diarrhea and constipation or irritable bowel syndrome.
6. Stimulate your bowels with a cup of coffee. Coffee can have a mild laxative effect, so adding a cup or two of coffee to your daily regimen may help to keep your bowels regular.
   • If you already drink coffee you may either need a bit more, or your body may be too habituated for it to provide relief.

Making Lifestyle Changes

1. Reduce your intake of foods that may cause constipation. Many of these foods are low in fiber, but high sugar and fat. This causes you to feel full before you've eaten enough fiber. Examples include:
   • Milk and cheese
   • Squash
   • Sugary foods like pastries, puddings, candy and cake
   • Prepackaged, processed foods which usually have added sugar, salt, and fat.
2. Eat many small meals rather than only a few large ones. Eating regularly will provide your digestive tract with continuous, low level stimulation and promote healthy digestion and regular contractions.
   • Eat slowly to give your body time to process your food. Eating too fast makes you more likely to overeat, overwhelming your digestive system.
   • Chew your food thoroughly to promote easy digestion and moderate portion sizes.
3. Exercise for at least 30 minutes per day. Exercise will stimulate your bowels to contract, moving food through your system.
   • The activity should be strenuous enough to increase your heart rate like fast walking, swimming, running, or biking.
   • Sometimes this works surprisingly quickly. Plan a route with frequent bathrooms available!
   • If you have other health concerns that might make exercise inadvisable, talk to your doctor first.
4. Reduce stress in your life. Stress has been shown to cause constipation and diarrhea, both of which may accompany hard, dry stools. Try relaxation techniques such as:
   • Deep breathing
   • Yoga
   • Meditation
   • Tai chi
   • Massage
   • Listening to relaxing music
   • Visualizing relaxing locations
   • Progressive muscle relaxation where you go through your body and deliberately tense and release each muscle group
5. Give yourself time on the toilet after each meal. You can simultaneously do relaxation techniques to promote movement through your system.
   • Spend at least 10 minutes on the toilet approximately 30 minutes after eating.
   • Put your feet on a low stool, so your knees are above your hips. This may make the bowel movement easier.
6. Use biofeedback to learn to release your pelvic floor muscles. This can make bowel movements easier.
   • The therapist will use a machine to measure the tension in your rectum and help you practice tightening and releasing your pelvic floor muscles.
   • Go to a therapist that works with a doctor or is recommended by your doctor to be sure that they are reliable.

Using Medications

1. Consult your doctor. Some prescription medications can cause constipation, such as opioid pain relievers. Your doctor may recommend changing your medication or adding a laxative to counter constipation. Your doctor may recommend either over-the-counter medicines or prescribe something stronger. See your doctor right away if you have:
   • Rectal bleeding
   • Severe weight loss
   • Fatigue
   • Severe abdominal pain
2. Lubricate your bowels with a small amount of mineral oil. Consult your doctor to determine what the right dose is for you.
   • Wait at least two hours after eating because it may prevent you from fully absorbing the nutrients.
   • It will work within the next six to eight hours.
   • Do not take it while lying in bed, because if you accidentally inhale some of it, it can cause pneumonia in your lungs. For this reason, do not give it to children younger than seven.
   • Do not take mineral oil if you are pregnant, as it may prevent the uptake of nutrients and cause bleeding in the newborn if taken for a long time.
3. Try stool softeners. These medications take moisture out of the intestines and use it to make your stool wetter.
   • Common ones include Colace and Surfak.
   • Drink an extra few glasses to water each day when you take them.
4. Use osmotic laxatives to make your stool wetter. These medications work by generating more liquid in your intestines. This will also stimulate your intestines to contract and move stool along, though it may take a few days. Common ones include:
   • Milk of magnesia
   • Magnesium citrate
   • Lactulose
   • Polyethylene glycol (MiraLax)
5. Consider stimulant laxatives. These are useful if your stool is soft enough to pass, but your intestines aren’t contracting to move it through. These medications stimulate contractions and should work within 12 hours. Common ones are:
   • Senna
   • Bisacodyl
   • Sodium Picosulphate
6. Remove a fecal impaction. If your rectum is blocked with hard, dry stool, you can get relief from a suppository, enema, or manual disimpaction.
   • A suppository is a capsule of medication that you put in your anus where it dissolves and is absorbed.
   • An enema is a liquid medication that is introduced into the large intestine via the anus. This should be done by the doctor.
   • Manual disimpaction requires your doctor or nurse to put on gloves and insert two lubricated fingers into the rectum to break up and remove impacted feces.

Warnings

• Do not take any medications, including over-the-counter medications without consulting your doctor if you are pregnant.
• Consult a doctor before giving any medications to a child.
• Read and follow all manufacturer’s instructions and recommendations from your doctor.
• If you are already on other medications, herbal remedies, or supplements, contact your doctor to ask if these medications could interact.

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Sources and Citations

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