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Causes of hard-to-pass stool and what to try

But some conditions that make pooping an uncomfortable chore are more serious and may require a visit to the doctor. Read on to learn what conditions may need medical treatment and what you can do to help relieve and prevent symptoms.

10 Reasons It Hurts When You Poop

Feeling some pain when you poop isn’t uncommon. Your diet, daily activities, and emotional state can all affect what it feels like to go number two, and the pain may only be temporary.

But some conditions that make pooping an uncomfortable chore are more serious and may require a visit to the doctor. Read on to learn what conditions may need medical treatment and what you can do to help relieve and prevent symptoms.

Anal fissures are tiny cuts that happen when anus skin cracks and often bleeds.

an area near your anus that looks torn
skin outgrowth near the tear
stinging or intense pain near your anus when you poop
blood in your poop or on toilet paper when you wipe
anal itchiness
burning sensation around your anus

They’re not too serious and usually go away without medical treatment in a little over a month.

Some treatments for anal fissures include:

If doctors aren’t the ones bringing in more money than they could possibly need, where is the money going? Insurance chief executive officers (CEOs) earn an average base salary of $584,000, hospital CEOs earn $386,000 and even hospital administrators earn more than a general doctor, with an average base salary of $237,000, MLive Media Group

taking stool softeners
hydrating with water and water-rich foods
eating about 20 to 35 grams of fiber per day
taking a sitz bath to improve blood flow and help muscles relax
applying hydrocortisone cream or ointment to reduce inflammation
using pain relief ointments, such as lidocaine, to reduce pain

Hemorrhoids, sometimes called piles, happen when the anus or rectum veins become swollen.

You may not notice an internal hemorrhoid in your anus, but external hemorrhoids can cause pain and make it hard to sit without discomfort.

pain when you poop
intense anal itching and pain
lumps near the anus that hurt or feel itchy
anal leakage
blood on toilet paper when you poop

Try the following treatments and prevention tips for hemorrhoids:

Take a warm bath for 10 minutes each day to relieve pain.
Apply topical hemorrhoid cream for itching or burning.
Eat more fiber or take fiber supplements, such as psyllium.
Use a sitz bath.
Wash your anus every time you bathe or shower with warm water and a gentle, unscented soap.
Use soft toilet paper when you wipe. Consider using a bidet for gentler cleansing.
Apply a cold compress to help with swelling.
Take nonsteroidal anti-inflammatory drugs (NSAIDs) for pain, including ibuprofen (Advil) or naproxen (Aleve).

More serious hemorrhoids may need to be surgically removed.

Constipation happens when you poop less than three times a week, and when you do, the poop comes out hard and with more trouble than usual. Pain is usually less sharp and may accompany pain in your lower gut from backup.

Common symptoms include:

hard, dry stool that comes out in small chunks
anus or gut pain while you poop
still feeling like you need to poop even after you go
bloating or cramping in your lower gut or back
feeling like something’s blocking your intestines

Follow these treatments and prevention tips for constipation:

Drink plenty of water — at least 64 ounces a day — to stay hydrated.
Reduce your caffeine and alcohol intake.
Eat plenty of fiber or take fiber supplements.
Eat foods with probiotics, such as Greek yogurt.
Reduce your intake of foods that can cause constipation, such as meat and dairy.
Get about 30 minutes of light exercise, such as walking or swimming, every day to keep your bowels moving.
Go to the bathroom as you feel it coming to keep stool from getting hard or stuck.
Try laxatives for severe cases but talk to your doctor before you take them.

Proctitis happens when the lining of your rectum, the tube where bowel movements comes out, becomes inflamed. It’s a common symptom of sexually transmitted infections (STIs), radiation treatments for cancer, or inflammatory bowel conditions such as ulcerative colitis.

pain when you poop
diarrhea
bleeding when you poop or wipe
mucuslike discharge from your anus
feeling like you have to poop even if you’ve just gone

Here are some treatment and prevention tips:

Use condoms or other protection when you have sex.
Avoid sexual contact with someone who has visible bumps or sores in their genital area.
Take any prescribed antibiotics or antiviral medications for infections, such as doxycycline (Vibramycin) or acyclovir (Zovirax).
Take any prescribed medications for radiation side effects, such as mesalamine (Canasa) or metronidazole (Flagyl).
Take over-the-counter stool softeners to help soften stool.
Take prescribed medications for inflammatory bowel diseases, such as mesalamine (Canasa) or prednisone (Rayos), or immunosuppressants such as infliximab (Remicade).
Get surgery to remove any damaged areas of your colon.
Get treatments like argon plasma coagulation (APC) or electrocoagulation.

Inflammatory bowel disease (IBD) refers to any condition that involves inflammation in your digestive tract. This includes Crohn’s disease, ulcerative colitis, and irritable bowel syndrome. Many of these conditions result in a lot of pain when you poop.

Common symptoms include:

diarrhea
feeling exhausted
pain or discomfort in your belly
blood in your poop
losing weight for no reason
not feeling hungry, even when you haven’t eaten for a while

Some treatments and prevention tips for IBD include:

anti-inflammatory medications, such as mesalamine (Delzicol) or olsalazine (Dipentum)
immunosuppressants, such as azathioprine or methotrexate (Trexall)
medications to control your immune system, such as adalimumab (Humira) or natalizumab (Tysabri)
antibiotics for infections, such as metronidazole (Flagyl)
diarrhea medications, such as methylcellulose (Citrucel) or loperamide (Imodium A-D)
pain medications, such as acetaminophen (Tylenol)
iron supplements to limit anemia from intestinal bleeding
calcium or vitamin D supplements to lower your risk of osteoporosis from Crohn’s disease
removal of parts of your colon or rectum, leaving a small pouch from your small intestine to your anus or to the outside of your body for collection
a low-meat, low-dairy, moderate-fiber diet with small amounts of caffeine and alcohol

Diarrhea happens when your bowel movements are thin and watery.

Diarrhea doesn’t always make pooping hurt. But wiping a lot and passing a lot of stool can irritate skin and make your anus feel raw and sore.

nausea
stomach pain or cramps
feeling bloated
losing too much fluid
blood in your poop
needing to poop often
fever
a large volume of stools

Treatment for diarrhea usually consists of rehydration, inserting an intravenous line if necessary, or antibiotics. Here are some prevention tips for diarrhea:

Wash your hands for at least 20 seconds with soap and water before and after you eat.
Wash and cook food properly, eat it right away, and put leftovers in the fridge quickly.
Ask your doctor about antibiotics before you visit a new country.
Don’t drink tap water when you travel or eat food that’s been washed with tap water. Only use bottled water.

Endometriosis happens when the tissues that make up the lining of the uterus, known as the endometrium, grow outside the uterus. They can attach to your colon and cause pain from irritation or scar tissue formation.

Other symptoms include:

pain during your period
lower abdominal or back pain and cramps before your period starts
heavy menstrual flow
pain during or after sex
infertility

Some treatments include:

pain medications, such as ibuprofen (Advil)
hormone therapy to regulate growth of tissues
birth control, such as medroxyprogesterone (Depo-Provera) injections, to mitigate tissue growth and symptoms
gonadotropin-releasing hormone (GRNH) to reduce estrogen that causes tissue growth
minimally invasive laser surgery to remove tissue
last resort surgical removal of the uterus, cervix, and ovaries to stop menstruation and tissue growth

STIs such as chlamydia or syphilis spread through anal sex can result in bacterial infections that cause your rectum to swell and make it painful to poop.

Both STIs are spread through unprotected sexual contact with someone who’s infected, and painful rectal swelling can also accompany symptoms like burning when you pee, discharge from your genitals, and pain during sex.

Some treatment and prevention tips for these STIs include:

antibiotics, such as azithromycin (Zithromax) or doxycycline (Oracea)
penicillin injections for severe syphilis
abstaining from sex while you’re being treated for either STI
using protection whenever you have sex, including oral or anal sex
getting tested for STIs regularly if you’re sexually active

Human papillomavirus (HPV) is a viral infection that can cause warts to form near your anus, genitals, mouth, or throat. Anal warts can get irritated when you poop, making you feel a rawness or stinging pain.

Untreated HPV can cause anal and cervical cancer. HPV can’t be fully cured. Warts may come and go, and your doctor may use laser or cryotherapy to remove warts. Make sure you get tested for STIs and for cancer regularly if you have an HPV diagnosis.

Prevention tips for HPV include:

getting the HPV vaccine if you’re under age 45
using condoms every time you have sex
getting Pap smears and regular health and STI screenings

Causes of hard-to-pass stool and what to try

Many people occasionally find that their poop is large and difficult to pass. This symptom is usually temporary and not a cause for concern. However, in some cases, uncomfortable bowel movements may be a sign of an underlying medical issue.

Various treatments and lifestyle adjustments may help a person pass the stool and prevent the issue from happening again.

In this article, we look at possible causes of large stools that are difficult to pass. We also discuss the treatment options and explain when to see a doctor.

There are many possible causes of large, painful, and hard-to-pass stools. They include:

Constipation

Constipation can cause stools that are hard to pass. The National Institute of Diabetes and Digestive and Kidney Diseases note that constipation is a common condition, affecting about 16 out of 100 adults in the United States. Among those aged 60 years and over, it affects 33 out of 100 people.

Possible causes of constipation include :

older age
lack of fiber in the diet
travel
ignoring the need to have a bowel movement
dehydration
lack of physical activity
changes in diet or eating habits

The symptoms of constipation may include :

fewer than three bowel movements in a week
hard, dry, or lumpy stools
difficulty passing a stool or pain on doing so
the feeling of an incomplete bowel movement

Fecal impaction

Fecal impaction is a condition in which the body is unable to move a large, dry, hard stool through the colon or rectum.

Causes of fecal impaction can include:

overuse of laxatives
some types of pain medication
lack of physical activity over an extended period
dietary changes
untreated constipation

The symptoms can include :

inability to pass a stool
stomach or back pain
difficulty urinating
nausea
vomiting
diarrhea that leaks out
changes in breathing or heartbeat

Fecal impaction can be dangerous without treatment, so a person should seek medical help straight away if they have symptoms of fecal impaction.

Bowel obstruction

A bowel obstruction is a severe condition in which an obstruction in the intestines blocks the normal digestion process. As a result, it can be difficult or impossible to move stools through to the rectum.

Possible causes of a bowel obstruction include:

foreign objects in the intestines
abnormal twists or growths of the intestines
inflammatory bowel disease
a tumor
scarring after surgery or infection
a hernia

The symptoms can include :

severe stomach pain or cramping
vomiting
a swollen or full-feeling stomach
constipation
inability to pass gas
loud sounds coming from the stomach

A bowel obstruction is an emergency, and a person will need medical help immediately.

Hypothyroidism

In people with hypothyroidism, the thyroid is unable to produce enough of the thyroid hormones, which affects many bodily functions.

Hypothyroidism can cause constipation. Other symptoms may include :

fatigue
dry skin and hair
being unable to tolerate the cold
depression
unexplained weight gain

Hypothyroidism is more common in females and those over the age of 60 years.

Irritable bowel syndrome (IBS)

IBS is a digestive issue that causes abdominal discomfort and frequent changes in bowel movements.

The symptoms may include :

stomach pain
constipation
diarrhea
bloating
gas
mucus in the stool
headaches
nausea
fatigue

There is no clear cause of IBS, but triggers can include:

stress
certain foods or drinks
bacterial infection or overgrowth in the gut
mental health disorders

Encopresis

Encopresis refers to children over 4 years of age being unable to control their bowel movements. Long-term constipation usually causes encopresis. The symptoms include:

soiling of clothing or defecating on the floor
painful, hard-to-pass stools
large stools that may clog the toilet
leaking of liquid stools

Pregnancy

Constipation can be a common symptom in pregnancy, when it can be due to:

changing hormones affecting the digestive system
the developing baby pressing down on the intestines
reduced physical activity
dietary changes

People may experience:

hard, lumpy stools
the feeling of an incomplete bowel movement
straining
infrequent bowel movements

Medications

Certain medications and supplements can cause hard-to-pass stools, including :

antiacids with aluminum and calcium
antiseizure medications
calcium channel blockers
diuretics
iron supplements
Parkinson’s disease medications
narcotics
medications to treat muscle spasms
some antidepressants

People may be able to treat large, hard-to-pass stools by making adjustments to their daily routine, such as :

increasing fiber intake by eating more fruits, vegetables, whole grains, legumes, and nuts
increasing water intake
avoiding low fiber foods, such as processed and fast foods
doing more physical activity
allowing time to have a bowel movement at a regular time of the day
eating meals at regular times and chewing thoroughly
responding to any urge to go to the toilet
avoiding straining or sitting on the toilet for too long

If people do not find these changes effective, or they have severe or additional symptoms, they may need medical treatment. Depending on the underlying cause, treatment may involve:

laxatives, stool softeners, or fiber supplements
prescription medication to encourage bowel movements
biofeedback therapy to retrain the muscles responsible for bowel movements
an enema, which is an injection of fluid or gas into the rectum to release stools
changing an existing medication if this is a potential cause
the manual removal of stools, if necessary
surgery, for example, to repair the colon or treat a rectal prolapse
therapy and positive toilet training techniques for children with encopresis
following a specific treatment plan, for conditions such as IBS

If dietary changes are not effective during pregnancy, a person can talk with their healthcare team about which treatment options are safe.

People should see their doctor if they have symptoms of fecal impaction. Treatments may include :

enemas or suppositories to soften the stool
the manual removal of the stool from the rectum
laxatives and increased water and fiber intake for prevention

It is advisable to see a doctor if at-home treatments are not effective or a person has any of the following symptoms:

constant stomach pain
inability to make a bowel movement, but there is leaking of liquid stool
being unable to control bowel movements
oily or greasy stools that are difficult to flush
hard, black stools
blood in stools
bleeding from the rectum
being unable to pass gas
vomiting
fever
unintentional weight loss
lower back pain

People should seek immediate medical attention if they have symptoms of fecal impaction or intestinal obstruction.

People may be able to treat large, hard-to-pass stools by making dietary changes and other simple lifestyle adjustments.

In some cases, hard-to-pass stools can cause serious complications if a person does not get treatment. If a medical condition is causing uncomfortable bowel movements, treating or managing the condition may help relieve the symptoms.

Large, hard-to-pass poop can be uncomfortable, but this issue may resolve with simple changes, such as increasing fiber intake, doing more physical activity, and drinking more water.

If home remedies are not effective, it is best to see a doctor for further treatment advice to prevent any complications.

Last medically reviewed on February 9, 2021

Constipation
Hypothyroid
Irritable Bowel Syndrome
GastroIntestinal / Gastroenterology
Pregnancy / Obstetrics

How we reviewed this article:

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Causes of hard-to-pass stool and what to try

10 Reasons It Hurts When You Poop