Why is feces hard, balls, lumps and how to soften it?

The act of defecation is the final stage of the digestion process. During it, the body removes processed food that is of no value to the body and harmful substances that have entered it from the outside or formed during life. This entire mass is called feces, which normally has a mushy consistency. While too liquid or hard feces may indicate some disorders in the body.

Today we will talk about a situation when the natural process of defecation occurs with difficulty and pain due to the fact that the feces have a very dense consistency.

Causes of Hard Stool

The appearance of hard feces and irregular bowel movements is a situation that requires detailed study, because the success of treating constipation primarily depends on identifying the cause that caused such a digestive disorder. And there can be many such causes. In addition, there is often not one, but several causes at once, one following from another. And treatment of the disease should consist of eliminating all possible causes of constipation.

What reasons can we talk about if a person complains that his feces have become hard, like sheep's or goat's, and defecation occurs irregularly with long intervals? Let's consider the possible risk factors for the appearance of complaints about very hard feces:

• The most common cause of constipation is considered to be poor nutrition. If a person's diet contains very few products containing soluble and insoluble plant fiber (vegetables, fruits, cereals, nuts, bran, etc.), the amount of feces will be scantier, and the consistency will be much denser. Fiber itself has virtually no nutritional value, but it absorbs water well, swells and significantly increases the volume of feces, which are accordingly excreted faster as soon as the brain receives a signal about the fullness of the rectum. And due to the water absorbed by dietary fiber, the feces become less solid.
• Psychological reasons that disrupt the nervous regulation of the act of defecation are also a fairly common cause of stool disorders. We may be talking about the following situations:
  • Depressive state. Its danger is that in such a state, various functions of the body slow down, their nervous regulation decreases. And the intestines are no exception. Its peristalsis is reduced, the chyme moves slowly through the intestines, losing more and more water (actually drying out), and the small amount of food received, the cause of which is considered to be apathy and lack of appetite, only aggravates the situation, reducing the frequency of bowel movements.
  • Sexual abuse. Forced anal sex and painful intercourse can cause the act of defecation to be associated with it. A person simply begins to restrain the urge to defecate out of fear of experiencing pain, which leads to a gradual atrophy of the physiological reflex itself.
  • An identical situation, but not associated with pain but with psychological discomfort, is observed if a person regularly holds back the urge to defecate while at work or in public organizations, due to awkwardness or certain inconveniences (lack of an accessible toilet, a public toilet with high traffic, etc.).
  • This also includes anorexia, which is considered a neuropsychiatric disorder and manifests itself in the form of a pathological fear of excess weight, disruption of metabolic processes and control over digestive function. As a result - lack of appetite, rare and difficult acts of defecation.
• Hypodynamia. The introduction of computers into various industries, the popularity of various types of earnings on the network, requiring constant user participation, lead to the fact that this problem is becoming more and more common than deficiencies in the diet. Insufficient physical activity leads to a decrease in the motor function of the intestine (peristalsis), which leads to delays in feces in the body and its "drying out". And if you add to this a diet poor in dietary fiber, very hard feces that do not come out for several days become an inevitable consequence of computerization and irrational nutrition.
• Constipation and hard stools can be caused by frequent use of laxatives. Occasional constipation, which occurs due to short-term disruptions in the body, should be treated for a short time, otherwise the intestines will get used to external stimulation and will no longer be able to remove feces from the body on their own.
• Sometimes the reflex is reduced because a person deliberately holds back defecation due to fear of pain that may be caused by diseases of the anus and rectum (cracks, hemorrhoids, thrombosis, or recent surgery on the rectum).
• Some medications can also reduce intestinal peristalsis, thereby causing constipation and hard stool: medications for depression, some antispasmodics, NSAIDs, antiulcer and antifungal agents, barium salt-based medications, medications used to combat Parkinson's disease, etc. Constipation most often occurs with the abuse of antidiarrheal medications.
• Some toxic substances, such as lead, also have a negative impact on the functioning of the intestines when they enter the gastrointestinal tract.

Among other things, hard stool and disrupted bowel movements can cause various diseases, the treatment of which will be the only way to get rid of problems with stool. We are talking about the following pathologies:

• Diseases of the endocrine system and metabolic disorders:
  • Deficiency of thyroid hormones produced by the thyroid gland (hypothyroidism)
  • Obesity grades 1-3
  • Diabetes mellitus
  • Potassium deficiency in the body (hypokalemia),
  • Excess calcium (hypercalcemia),
  • Porphyria with pigmentation disorder, etc.
• Neurological pathologies:
  • Parkinson's disease and its treatment
  • Pathologies of the spinal cord, occurring with damage to the innervation centers of the rectum and anus
  • Disruption of the innervation of the rectum associated with disorders of the parasympathetic nervous system
  • Diabetic polyneuropathy
  • Cerebral palsy
  • Multiple sclerosis, etc.
• Diseases of the digestive system:
  • Irritable bowel syndrome
  • Tumor processes in the intestines
  • Postoperative stenosis
  • Diverticula
  • Congenital pathology of the rectum, characterized by its enlargement compared to the norm (megacolon)
  • Enlargement of the rectum as a result of frequent constipation (megarectum)
  • Gastritis, duodenitis, peptic ulcer disease, accompanied by the use of antacid drugs, which can cause constipation, etc.

Hard feces in adults can also be caused by violations of the drinking regime. Normally, a person should drink at least 1.5-2 liters of liquid per day. If there is not enough water in the chyme, then the feces will be denser. The situation is considered especially problematic when a lot of fiber enters the body, but there is little liquid for its processing.

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Hard stool during pregnancy and after childbirth

Quite often women face the problem of hard stool during pregnancy. There are also many reasons for hard dry stool during this period:

• increased production of progesterone, which relaxes the muscles of the uterus, and at the same time the intestines, as a result of which its peristalsis weakens,
• disruption of bowel function due to compression by the uterus growing day by day,
• negative psychological background due to constant nervousness and fear of sudden termination of pregnancy, developmental disorders of the child, etc. (wouldn't a pregnant woman, with hormonal imbalances and maternal instinct, find a reason for fear and anxiety?!),
• a pregnant woman, especially at a later stage, may be afraid to push during the act of defecation due to fear of premature birth and hold back the urge to defecate, thereby disrupting the natural reflex,
• autoimmune, allergic and endocrinological diseases that worsen during pregnancy,
• physical inactivity in the last stages of pregnancy (for some it becomes difficult to move because of a huge and rather heavy belly, while for others, the doctor forbids active movement due to the threat of premature birth).

The nature of the causes of hard stool in pregnant women is such that it immediately becomes clear that this problem is widespread among women expecting a new addition to the family. But pregnancy is just the beginning. Very often after childbirth, the problem not only does not resolve, but on the contrary, worsens.

Well, firstly, the restructuring of the body and dietary restrictions can leave their mark on the work of the intestines, the disruption of peristalsis of which will not return to normal on its own. Secondly, the course of labor can also be different. After a difficult birth with tears or a cesarean section, a woman may simply be afraid to go to the toilet "for a big one". The reason for this may be the fear of suture divergence, pain from tears when straining, or hemorrhoids that appeared during pregnancy due to frequent constipation.

An important psychological reason why a woman may experience hard stool and constipation after childbirth is a certain discomfort due to the toilet, which can be dubbed the "someone else's potty" syndrome. Not everyone can go to the toilet "for a big one" in an unfamiliar environment, especially if the stall is inside a ward designed for several people.

Hard stool in a child

Unfortunately, constipation is not a purely adult problem. Hard stool and problems with bowel movements can also be observed in childhood. However, the reasons will be somewhat different:

• Hard stool in infants is most often caused by violations of the diet. Behind such a strict statement lies a banal transfer of the child to another type of feeding and improper introduction of complementary foods. The baby's digestive system, accustomed to breast milk, is gradually rebuilt to more dense food, during this period you can observe the compaction of the baby's feces, and rarer episodes of bowel movements.

Some mothers mistakenly believe that breast milk contains all the substances necessary for the child, including water. However, the amount of water that the baby receives during feeding is not enough for successful bowel movements. If the mother does not give the baby water between feedings, she should not be surprised that the child poops hard feces. This is caused by a lack of fluid in the body.

Hard stool in a newborn may be a consequence of congenital anomalies in the structure of the intestine, which require observation by a specialist, and sometimes surgical treatment.

• In an older child, hard stool and constipation are often the result of a low amount of fiber in the diet, as well as the abuse of food of animal origin (meat and dairy products). An unbalanced diet causes the formation of dense fecal masses, which, when bunched together, contribute to the stretching of the colon and a decrease in its sensitivity (impaired innervation).
• Hard stool in children often occurs against the background of drug treatment of some disease. The fact is that among the side effects of many drugs, constipation can be found, which means that they have a constipating effect, which is useful for diarrhea, but completely unnecessary if the child has normal mushy stool. Under the influence of drugs, the stool becomes denser and it is now more problematic to remove it from the body.

Constipation is sometimes caused by a disturbance of the intestinal microflora (dysbacteriosis) caused by a course of antibiotic therapy, which ideally should be accompanied by taking probiotics. By the way, an adult patient may also face such a problem.

• The cause of hard stool and problems with its passage can be considered dehydration of the body, which occurred due to insufficient amount of fluid entering the gastrointestinal tract, active consumption of fiber-rich foods against this background, prolonged fever and hyperhidrosis. Deficiency of fluid in the body can be a consequence of stomach upset or poisoning, accompanied by severe vomiting and diarrhea.
• Intestinal obstruction caused by fecal retention and hardening is not always a congenital pathology. Sometimes it occurs after swallowing a foreign body that creates a kind of plug in the intestine, or the appearance of neoplasms from pathologically overgrown tissue in the intestinal lumen or nearby organs.
• There are also psychological factors, but they take on a slightly different shade. Problems can arise during the period when the child is being potty trained. For example, the child does not want to poop, but is put on the potty just in case and asked to push. It is clear that the baby may not like this “game”, and he will deliberately hold back the urge to defecate so as not to sit on the potty.

Another problem is the beginning of a new life for the child when entering school or kindergarten. The child may hold back due to innate shyness, awkwardness in front of teachers and peers, or the "strange potty" syndrome. Overfilling the rectum with fecal matter that has compacted during the holding period leads to a decrease in its sensitivity. The baby does not always notice weak urges to "go big", empties the intestines less often, which means that his feces become harder and drier.

Be that as it may, parents need to closely monitor the nature of the child's stool and the frequency of bowel movements. If the child often holds back and his intestines lose their former sensitivity, this will be the beginning of intoxication of the child's body with harmful substances contained in the feces, due to the development of chronic constipation.

Pathogenesis

We will not go into all the intricacies of the digestive process, but will focus on the moment when sufficiently crushed and prepared for assimilation food (chyme) enters the intestine: first the small intestine, about 6 meters long, and then the large intestine, one and a half meters long. In order for the small intestine to fit into the abdominal cavity, it is arranged in loops. Using special equipment, you can see that the intestinal loops are in constant motion. This happens because the intestinal walls are forced to contract all the time, mixing the food and pushing it to the entrance to the large intestine.

The process of moving food through the intestines is called peristalsis. The entire path from the duodenum to the entrance to the large intestine is covered by chyme in 6-7 hours, significantly decreasing in size. After all, valuable nutrients in the small intestine are absorbed into the blood by the movement of special villi covering its inner lining.

The remaining part of the chyme, together with water, enters the large intestine, curved in the shape of the letter “P” and consisting of 6 parts, where the absorption of liquid, the breakdown of fiber and the direct formation of feces occur.

The walls of the large intestine contract less actively, so the remaining 1.5 m of the path food can travel for almost half a day, and its volume during this time decreases, depending on the nature of the food, to 150-300 g.

The act of defecation is associated with the final section of the large intestine - the rectum, which ends in the anus. The main task of the rectum is to accumulate and remove fecal matter. Fecal matter is removed from the body again due to contractile movements of the organ walls, and this process is regulated by the defecation center located in the lumbar region of the spinal cord. The work of the anal sphincters is controlled by innervation centers located in the brain and spinal cord, as well as in the anus.

In order for the chyme and then the feces formed from it to move through the intestines for no more than a day (ideally, the act of defecation should be performed daily), a person must consume a sufficient amount of food and liquid. The speed of movement and consistency of feces depend on intestinal peristalsis.

Violation of the contractile function of the intestinal walls leads to the fact that the chyme is poorly mixed, lumps up and lingers in the rectum for 2 or more days. During this time, the feces are completely dehydrated and compacted, which subsequently causes difficulties with its removal from the body. After all, unlike mushy feces, hard feces, lumped together into a large lump or individual balls, pass much more difficultly through the anus, the diameter of which is almost half that of the initial (proximal or closest to the duodenum) section of the large intestine.

This problem has its own name – constipation. According to statistics, 10 to 50% of the world’s population suffers from constipation. Moreover, the older a person becomes, the greater the likelihood of developing constipation. People over 55 are more prone to constipation. Children, including infants, young women, pregnant and nursing mothers are also at risk.

Such a large discrepancy in statistical results is due to differences in food preferences and traditions, as well as the fact that not all people are in a hurry to consult a doctor with such a delicate problem, the causes of which can be many. But in most cases, the problem of hard feces can be solved simply by changing lifestyle and food preferences. But there is a certain percentage of situations when constipation is a symptom of more serious pathologies that require appropriate treatment.

What types of hard stool are there?

Normally, bowel movements should occur if not daily, then at least once every 2 days. If this does not happen, we are talking about constipation, in which feces, as a rule, have a dense consistency and do not allow themselves to be “expelled” without noticeable straining.

There are acute and chronic constipation. The latter is said to occur if bowel movements are irregular for more than 3 months in a row and are accompanied by a certain discomfort and pain due to the high density of the stool.

Hard feces, as we have already mentioned, are more difficult to remove from the body than mushy ones, so the act of defecation takes longer and is accompanied by slight pain and strong tension in the abdominal muscles. If hard, dry feces are observed constantly, we are most likely talking about chronic constipation, the first signs of which are:

• loss of appetite,
• nausea due to the ingestion of toxic substances contained in feces and remaining in the body for a long time,
• chronic fatigue and rapid fatigability,
• deterioration of complexion, appearance of various purulent rashes on the skin.

The urge to defecate with chronic constipation is usually weak. If you do not go to the toilet immediately, the desire may disappear completely in a couple of minutes, and this is another day of delayed "poison" in the body.

Sometimes there are false urges to defecate, which can end with the passage of gases. Such urges can be quite painful, because gases stretch the intestines even more, trying to "squeeze" between dense accumulations of feces. Most often, such painful passage of gases occurs if the hard feces look like balls, tightly adjacent to each other.

Symptoms of hard stool can also include difficulty in passing it with intense urges and a prolonged absence of productive urges to defecate. The appearance of the stool may also vary slightly. In one case, you can see a thick, dense "sausage" that passes through the anus with difficulty, in another - several stuck-together, shapeless elements, in a third - very hard stool consisting of balls resembling the feces of goats or sheep.

Hard stool is a flexible concept, and any doctor will tell you this. In essence, hardened feces in the intestines are one of the symptoms of constipation. But on the other hand, the nature and appearance of such feces may differ, which indicates different types of constipation and a variety of its causes.

One of these types of constipation is considered to be hard feces in balls. Such feces are most often referred to as: hard sheep feces or "goat balls". Individual lumps of feces in this case are small in size (up to 1-2 cm).

According to doctors, it is unfair to call such feces a full-fledged disease. Rather, it is a functional disorder, the most common causes of which are considered to be dysbacteriosis and irritable bowel syndrome ("lazy" bowel).

Symptoms of this disorder often include: episodes of severe weakness, painful bloating due to excess gas accumulation, high blood pressure, and headaches.

Hard grains in the stool of an adult may indicate problems with the gastrointestinal tract, as a result of which food is poorly digested. Microscopic hard "stones" can be found in the stool and in cholelithiasis, because small stones from the gallbladder are excreted naturally or after ultrasound treatment through the intestines along with the stool.

Small and hard white or light yellow grains are often found in the stool of infants, especially those who are breastfed. In this case, there is no need to look for pathology. Such stool is considered normal and most likely indicates that the mother has fatty milk.

White hard feces also do not always indicate a disease. The main pigment of feces - stercobilin - gives them a brown tint. However, the color of feces largely depends on the food we eat. Dairy products can give excrement a white color. If the diet consists mainly of them and plant foods, the feces will be very light, almost white. And if, in addition, a person eats few foods containing fiber, there will be little feces, they will pass less often and will become quite hard.

Discoloration of feces becomes a frequent symptom of cholelithiasis, when the bile ducts are blocked by stones. The reason for such a change in the color of feces is the absence of the pigment stercobilin. An identical situation can be observed in inflammatory liver lesions (for example, in acute hepatitis), inflammation of the bile ducts (angiocholitis) or pancreas (acute pancreatitis), dysbacteriosis, viral pathologies. In this case, feces acquire a light gray or dirty white color.

Hard, dark stool may also seem suspicious. But before you panic, you need to figure out what you ate the day before and what medications you took. Some foods (beetroot, dark grapes, prunes, blueberries, black currants) can change the color of stool to a darker color within 3 days. Eating a large amount of the above-described treats can result in almost black stool, and if intestinal motility is impaired, it will also be hard, usually in the form of balls.

Medicines can also make stool dark or even black. We are talking about iron preparations prescribed for anemia, activated carbon and stomach medicines based on bismuth (for example, the advertised "De-Nol"). Such a side effect of the drugs, however, is not a reason to cancel them.

A more dangerous cause of black stool may be gastrointestinal bleeding. But in this case there are also other unpleasant symptoms in the form of abdominal pain, nausea and vomiting of dark brown color, severe weakness.

But if the stool is hard, but not black, but normal in color with blood, we are talking about bleeding in one of the sections of the rectum. With constipation, due to difficulties in removing feces of a hard consistency, the anus undergoes strong tension, but since it has a limited diameter, it is likely that cracks can form directly in the wall of the anus.

This is, of course, the lesser of two evils, because bloody stools are also observed with hemorrhoids and cancerous diseases of the stomach and intestines.

Well, black feces are, of course, suspicious, but green feces are even more alarming. Although an explanation can be found for this phenomenon. In most cases, green hard feces of a dark shade occur due to the abuse of products containing iron (leafy greens and vegetables, fruit juices, cereals, sea fish) or artificial colors (for example, sweets with dyes). It is also necessary to take into account the fact that the green color of feces in this case can persist for 5 days.

Bright green feces are common among vegetarians who consume large quantities of this color. Some vitamin and mineral complexes, natural laxatives, kelp, iodine preparations, and sorbitol can give feces a green tint.

Pathological causes of green feces include: parasitic infection (lamblia, salmonella), food poisoning or allergies, viral pathologies, the presence of unchanged bilirubin in the feces, Crohn's disease, gastric and duodenal ulcers, diabetes, thyrotoxicosis, too rapid passage of bile through the gastrointestinal tract, etc.

By the way, such feces are considered normal for newborns. During the first month of life, the baby's feces are greenish in color, and only then begin to change. And if the baby does not receive enough liquid, his feces become not only green, but also hard.

As in childhood, it can turn green during teething, a change in the type of food or milk formula, intolerance to milk protein. Among the pathological causes, dysbacteriosis and liver and gallbladder dysfunction can be distinguished.

Yellow hard feces can be observed in people with problems in the form of impaired motility and digestion in the small intestine. If the feces are light yellow, the cause is most likely diseases of the pancreas, less often - the liver or gall bladder. Sometimes yellow feces are an indicator of increased fermentation in the intestine or the predominance of dairy products in the diet.

If the stool is not just hard, but also dry (as if dried out), the reason lies either in a lack of fluid, or in a disruption in the formation of feces due to problems with the gallbladder or a disruption in intestinal motility.

So far we have talked about the types of hard stool and situations when constipated stool contains bloody or hard sand-like inclusions. But sometimes hard stool can be excreted together with mucus. What does such a symptom indicate, because ideally, mucus should not be visually determined in the stool?

First, you need to figure out where the mucus comes from. For example, with inflammatory pathologies of the upper respiratory tract, mucus can simply be swallowed and enter the intestines, where it mixes with feces. In the intestines, excessive mucus production can be provoked by kicking products (for example, bananas, cottage cheese, oatmeal porridge, watermelon). In infancy, mucus in the feces is considered an indicator of insufficient maturity of the digestive system.

However, in some cases, mucus in the stool may also indicate the development of various diseases: inflammation in the small or large intestine, tumor processes in the lower parts of the gastrointestinal tract, hemorrhoids, dysbacteriosis, irritable bowel syndrome, intestinal infections, cystic fibrosis and some other pathologies. Mucus also appears if the absorption of various nutrients is impaired: fats, lactose, etc.

Constipation with hard, difficult to pass feces is an unpleasant thing. But no less unpleasant is the situation when the first portion of feces is hard and large, and then the stool has a normal consistency. In such a case, the urge to defecate is strong and painful, and even after defecation there is some discomfort.

The reason for such a "misunderstanding" can be considered to be low acidity of gastric juice and insufficient flow of bile into the intestine. A similar phenomenon, called cork-shaped stool, can also be observed in irritable bowel syndrome, accompanied by constipation. In this case, the appearance of mucus in the feces is not excluded.

Consequences and complications

Hard feces in any of its manifestations are considered the most likely cause of constipation. Short-term constipation itself is unlikely to cause much harm to a person. Perhaps some discomfort, pain and a certain chance of getting a painful crack in the anus at some point.

Another matter is long-term difficulties with stool removal or chronic constipation. Here the list of complications is much longer: hemorrhoids, colitis and reflux enteritis (inflammation of the small intestine), proctosigmoiditis (inflammation of the distal parts of the large intestine), paraproctitis (inflammation of tissues in the anal area), megacolon (increase in size or simply stretching of the large intestine). The consequences of megacolon are even more severe and frequent constipation.

It is important to remember that harmful substances and toxins are removed from the body along with feces. If feces have a hard consistency, as a result of which it is more difficult to move through the intestines and is retained in it for a long time, toxins from feces gradually pass into the blood, poisoning the entire body.

Stagnation of fecal matter in the intestines contributes to the accumulation of carcinogenic substances in the form of waste products of the intestinal microflora. And carcinogens, in turn, contribute to the development of malignant tumor processes. Thus, chronic constipation, in which many of us do not see any danger, can cause cancer of the colon or its part - the rectum. This means that constipation is not something to joke about. Everything must be done so that the hard feces acquire a normal consistency and the intestines can remove it from the body in a timely manner and without much difficulty.

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Diagnostics

When a person comes to see a doctor complaining of hard stool and painful, difficult bowel movements, the doctor immediately asks how long ago this symptom appeared and whether it is related to eating disorders. The questions of food preferences and the amount of water drunk per day are clarified, as well as the presence of other unpleasant symptoms, such as weakness, fever, nausea, vomiting, etc.

After listening to the patient's complaints and asking leading questions, the doctor moves on to studying the patient's medical history, asking whether there have been cases of constipation in close relatives, and determining a preliminary diagnosis (acute or chronic constipation).

Chronic constipation is defined as a patient who answers positively to at least 2 questions, and the symptoms described must be observed for at least 3 months in a row (if constipation is not constant, then for six months):

• defecation occurs less than 3 times a week,
• solid whole or "sheep" feces occur in at least 25 percent of bowel movements,
• there is strong tension in the rectum during defecation (in more than 25 percent of cases),
• in a quarter or more of the episodes of defecation, there remained a feeling that the intestines were not completely emptied,
• In some cases of hard stool, it was necessary to empty the bowels with the help of hands.

The doctor will definitely ask to describe the nature of the stool: color, smell, consistency, shape. If the therapist refers you to a proctologist, the latter will definitely conduct a digital rectal examination of the rectum. The procedure is, of course, unpleasant, but necessary for pathologies of the large intestine.

Treating constipation without finding out its cause is like poking a finger into the sky. And since there can be a great many reasons for hard feces as a symptom of constipation, and many of them are pathological, you can’t do without analyzing the excrement.

What tests can be prescribed for constipation:

• general blood test (prescribed in most cases to clarify the patient's condition and diagnose inflammation),
• stool test to detect occult blood,
• stool microflora test (bacterial culture),
• coprogram (detailed analysis of feces).

If a tumor process is suspected, a biopsy of the mucous membranes of the colon is performed, and a cytological and histological examination of the biopsy is carried out. Laboratory tests may be prescribed to identify disorders in the functioning of the secretory organs of the digestive system.

Instrumental diagnostics of chronic constipation includes:

• X-ray of the pelvic organs, which allows us to assess the functional state of the colon, its peristalsis, size, as well as congenital defects, strictures and other anomalies,
• irrigoscopy (contrast radiography),
• colonoscopy (endoscopic examination of the large intestine),
• capsule endoscopy (instead of an endoscope, the procedure uses a capsule with a built-in mini camera, which is swallowed like a pill and is excreted naturally after 8-9 hours; during this time, the camera continuously records),
• CT scan of the colon (it can be called a virtual colonoscopy).

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Differential diagnostics

Differential diagnostics in case of hard stool enables the doctor to differentiate pathological causes from physiological and psychological ones. If the tests and instrumental examination do not reveal any deviations, the doctor prescribes additional studies that help to identify the dependence of the unpleasant symptom on the patient's psychoemotional state or hormonal background, medication intake, including laxatives, or lifestyle.

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Treatment of constipation with hard stool

Many patients, having discovered “sheep balls” instead of the usual sausage-shaped feces, panic, not understanding the reason for such a change in the appearance and characteristics of feces. Not knowing what to do if the feces are hard and cause a lot of unpleasant sensations (and even fear) during defecation, they do not rush to the doctor with such a delicate problem, but try to find an answer on the Internet.

And the answer is one: you should not take risks by self-medicating. Constipation is not a normal condition of the body, and therefore requires certain treatment. Prescribing laxatives and enemas to yourself can only worsen the situation, because a more serious problem may be hidden behind banal constipation.

Doctors take the treatment of constipation with hard stool quite seriously. Therapy for this stool disorder is comprehensive and includes:

• Lifestyle adjustments (from physical inactivity to active), revision of medications taken in favor of those drugs that do not cause constipation, an increase in the daily volume of liquid consumed (at least 2 liters) and fiber in the patient’s diet (at least 35 g per day).
• Taking mild laxatives:

• swelling action, which promotes water retention and an increase in the volume of feces (Mukofalk, Polycarbophil, Methylcellulose, etc.),
• osmotic, which try to attract water into the intestines and increase its volume in the stool, thereby softening hard fecal masses (Macrogol, Sorbitol, Mannitol, Duphalac, saline laxatives represented by magnesium sulfate or hydroxide, sodium phosphate or sulfate, etc.),
• lubricants in the form of rectal suppositories based on glycerin or petroleum jelly (facilitate the passage of feces through the intestines).

Physiotherapeutic treatment: electrotherapy (abdominal faradization), exposure to low-power direct current (galvanization), UV irradiation, paraffin applications to the pelvic area, heating the abdomen with current (diathermy), electrophoresis with antispasmodics, various thermal and massage procedures.

• Prescription of stimulant laxatives (Bisacodyl, castor oil, Senadexin, etc.), prokinetics (Domperidone, Metoclopramide, etc.), antispasmodics (Niaspam, Dicetel, Mebererin, etc.).

Cleansing the intestines with enemas (prescribed when taking laxatives is insufficient).

Treatment is carried out in stages. The next stage is only moved on if the previous one did not give a positive result. In most patients with intestinal motility disorders, the problem is solved at the first stage. If the problem of constipation is complicated by more serious pathologies, they move on to the second, and in advanced cases, to the third stage of therapy, which is carried out in parallel with the treatment of the underlying disease.

Additionally, the doctor may prescribe vitamin therapy. Vitamins A, C and B1 are useful for constipation, as they improve digestion and intestinal innervation. The above vitamins can be taken with food or in the form of pharmaceutical preparations.

Surgical treatment for constipation with hard stool is indicated only in cases of ineffective conservative therapy, congenital anomalies or malignant tumors in the gastrointestinal tract.

Hard stools and laxatives

Let's look at how laxatives can help solve the problem of hard stool and painful, irregular bowel movements.

"Mukofalk" is a laxative drug with swelling action on a plant basis (plantain seeds). The active substance of the drug is able to absorb water 40 times more than its own weight, due to which the volume of feces increases. In parallel, plantain seeds have a stimulating effect on the intestines, improving its peristalsis.

The medicine is produced in the form of a powder, which is placed in single-use sachets. The laxative should be taken 1 sachet at a time. The frequency of administration can reach 6 times a day. Before use, the powder from the sachet is mixed with cold boiled water in the amount of 150 ml. During the treatment, drink a lot of water (2 liters or more).

Contraindications to the use of the drug are: intestinal obstruction or high probability of pathology, intestinal structure anomalies, water-electrolyte imbalance, severe diabetes. In pediatrics, it is used from 12 years of age.

Side effects of Mucofalk include: allergic reactions, temporary increase in gas formation, and a feeling of fullness in the intestines.

"Macrogol" is a drug based on the polymer of polyhydric alcohol ethylene glycol, which forms hydrogen bonds with water particles. In the gastrointestinal tract, macrogol binds water and transfers it into the chyme, and then into the feces, thereby liquefying the feces. At the same time, it stimulates intestinal motility and prevents the release of electrolytes with feces.

The drug is prescribed for both therapeutic and diagnostic purposes (for example, before colonoscopy). The release form is the same as the previous drug.

The drug should be taken only once a day in the amount of 1-2 packets, the contents of which are poured into ½ glass of water. Drink the medicine in the morning, on an empty stomach. The result is noticeable on the 2-3 day.

The drug is not prescribed to patients with ulcers and erosions inside the intestine, ulcerative colitis, Crohn's disease, toxic dilatation of the colon, complete or partial intestinal obstruction, abdominal pain that occurs for an unknown reason. The drug is contraindicated in case of hypersensitivity to its components. In pediatrics, it is used from the age of 8. Caution is observed in case of heart failure and dehydration.

Side effects of the osmotic laxative include: allergic reactions in the form of swelling, hyperemia, rash, pain and heaviness in the abdomen, development of diarrhea, bloating, attacks of nausea and vomiting, strong urge to defecate, requiring immediate resolution.

"Duphalac" is a lactulose-based syrup with hyperosmotic action. Among its effects are stimulation of intestinal peristalsis and improvement of absorption of phosphates and calcium salts.

It is used to regulate the rhythm of emptying the colon and soften hard feces. It is available in the form of sachets with powder.

The drug can be taken in its pure form or diluted with water. The medicine is not kept in the mouth, it is swallowed immediately. The dosage is selected by the attending physician (usually from 15 to 45 ml). Children's dose is 5-15 ml, depending on age. Frequency of administration is 1-2 times a day.

Adults take the medicine in powder form 1-3 sachets per day, diluted in water.

Therapy with the drug requires drinking at least 1.5 liters of water per day. The result of the treatment appears after 2-3 days.

Laxatives are not prescribed for galactosemia, obstruction or perforation of the stomach or intestines, galactose and fructose intolerance and lactase deficiency, hypersensitivity to the components of the drug.

The most common side effects are: development of diarrhea, bloating and pain in the abdomen, attacks of nausea and vomiting.

"Senadexin" is a herbal preparation with a stimulating effect. It has a rapid effect (within 6-12 hours). The active substance of the preparation - senna leaves - has an irritating effect on the intestinal receptors, thereby stimulating its contraction (motility). In parallel, it has an osmotic effect, attracting water and diluting feces. Increases the pressure of feces on the intestinal walls, thereby stimulating peristalsis.

The drug is prescribed for intestinal atony (reduced tone and peristalsis), as well as preparation for radiography. It is available in the form of brown tablets.

Take the drug 1-2 tablets 1-2 times a day, but no more than 4 tablets per day.

Contraindications to the use of laxatives are: individual intolerance to the components of the drug, Crohn's disease, intestinal obstruction, ulcerative colitis, gastrointestinal bleeding, uterine bleeding. The drug is not prescribed for acute appendicitis and other intestinal pathologies in the acute stage, peritonitis, peptic ulcer, cystitis, water-electrolyte imbalance, spastic constipation, strangulated hernia, bleeding from the anus. In pediatrics, the drug is allowed to be used from 12 years of age.

Side effects of Senadexin are very rare and include mild allergic reactions, changes in urine color, abdominal pain and diarrhea, muscle weakness and heart problems due to loss of electrolytes (long-term use of high doses).

Folk remedies

As we have already mentioned, not everyone is in a hurry to see a doctor with the problem of hard stool. Some feel awkward discussing such a delicate issue, others are afraid of numerous and far from pleasant examinations, and others simply do not have the opportunity to use the services of doctors. But the problem remains and requires a quick solution, until other dangerous pathologies begin to develop against the background of chronic constipation.

For those who wonder how to soften hard stool without medical intervention and without harming their health, we can recommend several recipes of traditional medicine. However, it is necessary to remember that none of the remedies in the composition of traditional treatment can be used if the cause of hardening and irregularity of the stool is some kind of obstacle in the intestine, which slows down the movement of feces through the intestine (volvulus, tumor in the intestine, adhesive disease, a lump of undigested food, a foreign body in the gastrointestinal tract, anomalies in the development of the organ, spasms).

Some sources recommend softening the stool with an enema with soapy water. Despite the fact that the effect of such a procedure occurs in a short time (within 10-15 minutes), doctors do not advise rushing with such a radical remedy. To begin with, you can try to include crushed flax seeds and bran in your diet. You can eat them as part of your usual dishes, adding 1-2 teaspoons per serving. It is better to do this in the morning and afternoon hours, so that there is an opportunity to dilute the folk "medicine" in the stomach and intestines with plenty of water (2-2.5 liters per day).

Table and vinaigrette beets increase the amount of feces and soften their consistency. They can be consumed both raw and boiled. Beet juice, which should be drunk between meals three times a day, also has a good effect. At least a glass of juice should be drunk per meal. Freshly prepared juice should be left to stand for an hour before use.

In the morning, you can add potato and carrot juice to beetroot juice, which also soften the stool, have a beneficial effect on the gastrointestinal mucosa and help remove toxins that accumulate in the body due to chronic constipation. The mixture of juices or any of the above juices separately should be drunk on an empty stomach an hour before breakfast, ¾-1 glass.

Traditional healers believe that cucumber brine helps to quickly and effectively solve the problem of hard feces. We are not talking about a marinade, but about a brine, which consists of water and salt with the addition of spices (for example, dill). The brine should be drunk every day for 1-2 glasses. Heated cabbage brine has an identical effect.

You can ease bowel movements with the help of vegetable oils. Any oils that you have in your kitchen at home will do: sunflower, olive, corn. You need to drink 1-2 tablespoons of oil at a time. Repeat the intake of oils 3-4 times a day. If you can’t swallow the oil in its pure form, add it to food.

Herbal treatment is also considered effective for constipation. Take, for example, the same dill. Its seeds, like caraway seeds, are able not only to solve the problem of increased gas formation, but also to normalize stool. For this purpose, prepare an infusion of 1 spoon of seeds and 1.5 cups of boiling water (insist for 30-40 minutes), filter and squeeze out the seeds. The composition is divided into 4 parts, which are consumed between meals.

Among other recipes for constipation, it is worth highlighting: nettle infusion (1 spoon per glass of water) or oregano (2 spoons per glass of water), a decoction of seeds and an infusion of burdock roots (1 spoon per glass of water), senna herb brewed with boiling water (1 spoon per ¾ glass of water).

No matter how effective folk remedies are, if constipation is caused by intestinal atony, it is impossible to get rid of it without normalizing your lifestyle and diet.

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Homeopathy

Not only traditional and folk medicine, but also homeopathy have a sufficient set of means to help those who have hard stool and constant constipation. Homeopathic medicines have a minimum number of contraindications and side effects, which means that with the right approach to their use, you can get rid of constipation quickly and safely.

Homeopathic medicines can have different effects, each normalizing a person’s stool in its own way, so they should be prescribed by a specialist who is familiar with the mechanism of action of the drugs.

The homeopathic preparation Sulphur has a positive effect on the functioning of the lazy intestines, improving portal (abdominal) blood circulation.

The medicine Nux vomica helps relieve spasms if hard stool appears due to irregular bowel movements. And a person cannot go to the toilet "for a big one" because of the spasmodic contraction of the anal sphincter during defecation.

A homeopathic remedy based on horse chestnut (Aesculus hippocastanum) will help with constipation due to hemorrhoids and anal fissures.

Anacardium will be useful for both atonic and spastic constipation, it will also help relieve unpleasant sensations associated with food intake (nausea, dyspepsia, abdominal pain).

If the cause of constipation is insufficient flow of bile into the intestines when chyme gets there, Lycopodium will help to increase the outflow of bile. It is effective in case of "sheep" feces. However, as is Thuja.

If hard feces come out together with mucus, and especially if there are cracks in the anus, the drug Graphitis will be useful. It is used to treat diarrhea, prescribing different dosages.

To increase the tone and motility of the rectum, homeopathic preparations are prescribed: Sepia, Silicea, Opium, Barium carbonicum. The last two preparations are especially often used in the treatment of atonic constipation in the elderly.

Which of the described drugs will be effective in each specific case is decided by a homeopathic doctor, taking into account many nuances that are incomprehensible to the uninitiated reader. He also determines in what dosage and at what time the drugs for constipation should be taken.

Prevention

Isn't this a reason to take up prevention and timely treatment of constipation? After all, it is not so difficult to prevent constipation, unless we are talking about tumors, structural anomalies or foreign bodies in the intestines. A balanced diet with sufficient plant fiber and drinking 1.5-2.5 liters of water will not only help to avoid constipation and hard feces, but will also have a positive effect on your well-being and skin condition.

It will help to prevent chronic bowel disorders and timely visit to the doctor regarding emerging diseases of the digestive, endocrine and nervous systems. Constipation is usually a late consequence of such pathologies. If the disease is caught and treated at an early stage, serious bowel disorders may not occur.

A person's lifestyle also plays an important role. Hypodynamia often causes the development of many diseases, and constipation is no exception. Intestinal peristalsis decreases as the physical activity of its owner decreases. Therefore, people engaged in intellectual work should take breaks not in the smoking room, but in the gym or at the stadium. And working people need to eat well in the canteen or cafe, and not escape with snacks (crackers, chips, buns, fast food), because of which the problem of constipation and hard feces has become especially relevant.

Forecast

No matter how much discomfort hard stools can cause, the situation is not hopeless. In most cases, you don’t even have to resort to serious treatment, limiting yourself to increasing the amount of fiber in your diet and increasing physical activity.

If diet and lifestyle changes do not help, they move on to drug treatment. In order for the fight against constipation to be effective and have a lasting result, it is important to follow the doctor's advice in choosing the type of laxative. Do not immediately resort to stimulants that cause addiction. Long-term use of such drugs can only aggravate the situation when the intestines simply become too lazy to empty themselves.

The prognosis for treating hard stool largely depends on the cause of constipation. It is clear that if constipation is only a symptom of a more serious disease, only therapy for the underlying pathology will help solve the problem. Symptomatic treatment in this case will have a temporary result.

The worst prognosis is in advanced cases, when constipation has led to the development of colon cancer. And here everything depends on the stage of the disease, the presence of metastases in the lymph nodes and various human organs. Treatment is strictly surgical. At stage 4 of the disease, people live no more than 3 years.

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