Dealing with Painful Hard Bowel Movements: Tips for Relief

Constipation with large, hard, and painful stools?

Three days ago, I had a cold and diarrhea, and it seems like there is a tear at the anal opening, so I held off on bowel movements for two days.
However, now I have a strong urge to defecate, but the stool is too hard and large, and somewhat sticky.
I am straining at the anus but can't pass it (it's painful).
What should I do? (I have used digestive enzymes, but I gave up because it caused some burning.) (P.S.
I eat fruits and vegetables every day.)

Hao tong, 20~29 year old female. Ask Date: 2016/05/16

Dr. Ke Fangxu reply Surgery

Based on your description, it seems to be an anal fissure.
The typical symptoms include pain during bowel movements accompanied by slight bleeding.
The primary cause of anal fissures is usually hard stools; however, diarrhea, frequent bowel movements, or prolonged straining can also lead to fissures.
It is recommended to improve bowel habits and take warm sitz baths to alleviate symptoms.
Topical ointments and suppositories can also be used for treatment.
If symptoms persist for more than a week without improvement, it is advisable to consult a physician for further evaluation.

Reply Date: 2016/05/16

More Info

Dealing with painful hard bowel movements can be quite distressing, especially when accompanied by symptoms like anal fissures or discomfort. It’s essential to address both the immediate pain and the underlying causes of constipation to find relief. Here are some strategies you can consider:

1. Hydration is Key
One of the most effective ways to soften stool is to increase your fluid intake. Aim for at least 8-10 glasses of water a day. Staying well-hydrated helps to keep the stool moist and easier to pass. If plain water is not appealing, consider herbal teas or broths, which can also contribute to your daily fluid intake.

2. Increase Dietary Fiber
While you mentioned that you eat fruits and vegetables, it’s crucial to ensure you’re consuming enough fiber overall. The recommended daily intake for adults is about 25-30 grams. Incorporate high-fiber foods such as whole grains, legumes, nuts, and seeds. Foods like oats, chia seeds, and flaxseeds can be particularly beneficial. If you find it challenging to get enough fiber from food, consider a fiber supplement, but introduce it gradually to avoid bloating or gas.

3. Gentle Laxatives
If dietary changes alone aren’t effective, consider using a gentle over-the-counter laxative. Options like polyethylene glycol (MiraLAX) or docusate sodium (Colace) can help soften the stool and make it easier to pass. However, it’s important to use these as a short-term solution and not rely on them long-term without consulting a healthcare provider.

4. Warm Baths and Relaxation Techniques
Taking a warm bath can help relax the anal sphincter and relieve pain associated with bowel movements. This can also soothe any irritation caused by hard stools. Additionally, practicing relaxation techniques such as deep breathing or meditation can help reduce anxiety related to bowel movements, making it easier to go.

5. Avoid Straining
Straining during bowel movements can exacerbate pain and lead to further complications like anal fissures. When you feel the urge to go, try to respond promptly. If you’re having difficulty, consider using a footstool to elevate your feet while sitting on the toilet. This position can help align your colon for easier passage of stool.

6. Consult a Healthcare Provider
If your symptoms persist or worsen, it’s crucial to consult a healthcare provider. They can evaluate for underlying conditions such as irritable bowel syndrome (IBS), hypothyroidism, or other gastrointestinal disorders that may be contributing to your constipation. They may also recommend further tests or treatments tailored to your specific needs.

7. Monitor Your Symptoms
Keep track of your bowel habits, including frequency, consistency, and any accompanying symptoms like pain or bleeding. This information can be invaluable for your healthcare provider in diagnosing and treating your condition effectively.

Conclusion
In summary, managing painful hard bowel movements involves a combination of dietary adjustments, hydration, gentle laxatives, and relaxation techniques. It’s essential to listen to your body and seek medical advice if your symptoms do not improve. Remember, maintaining a healthy digestive system is a lifelong commitment, and making gradual changes can lead to significant improvements over time.

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