Why Is My Stool Hard at the Front and Normal at the Back? - Surgery

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The stool is hard and dry at the beginning, but normal at the end?


Hello doctor, I have a bowel movement every day, and the amount is about 2 to 3 pieces, roughly the size of a fifty-cent coin.
However, in the past few days, the front part of my stool has been dry and hard, while the rest is normal and soft.
The first time the dry and hard front caused a slight tear at the anus.
I thought it would heal quickly, but now the dry and hard front keeps causing a tear every day.
I drink plenty of water every day and try to eat more fruits and vegetables.
What could be the reason for this situation, and how should I address it?

Joi, 20~29 year old female. Ask Date: 2017/10/11

Dr. Ke Fangxu reply Surgery


Constipation in young women often presents in this manner.
If dietary and lifestyle changes do not help, medication may be necessary.
It is advisable to consult a physician for evaluation.
If you prefer not to take medication temporarily, you can increase your intake of dietary fiber and try to establish a regular bowel habit.

Reply Date: 2017/10/11

More Info


The issue you're experiencing with your stool being hard at the front and normal at the back can be quite uncomfortable and concerning. This condition is often related to several factors, including diet, hydration, and bowel habits.
Firstly, it's important to understand that the consistency of stool can vary based on the transit time through the intestines. When stool moves too slowly through the colon, it can become dehydrated, leading to hard, dry stools. The fact that the front part of your stool is hard while the back is normal suggests that the stool is becoming dehydrated as it sits in the colon for an extended period. This can happen if there is a delay in the urge to defecate or if you are not fully emptying your bowels during each visit to the bathroom.

Even though you mentioned that you drink plenty of water and consume fruits and vegetables, which are essential for maintaining healthy bowel movements, there may still be other factors at play. Here are some potential reasons and recommendations to address your situation:
1. Dietary Fiber: While you are eating fruits and vegetables, it’s crucial to ensure you are getting enough soluble and insoluble fiber. Soluble fiber (found in oats, beans, and fruits) helps to soften stool, while insoluble fiber (found in whole grains and vegetables) adds bulk. Aim for a balanced intake of both types of fiber.

2. Hydration: Although you mentioned drinking a lot of water, it’s essential to ensure that your hydration levels are adequate. Sometimes, people may not drink enough fluids relative to their fiber intake, which can lead to hard stools. Aim for at least 8-10 cups of water a day, and consider increasing your intake if you consume high-fiber foods.

3. Bowel Habits: Pay attention to your bowel habits. If you feel the urge to go, try not to delay it. Holding in stool can lead to harder stools as water is absorbed from the stool in the colon. Establishing a regular schedule for bowel movements can also help.

4. Physical Activity: Regular physical activity can stimulate bowel movements. If you have a sedentary lifestyle, consider incorporating more movement into your daily routine, such as walking or other forms of exercise.

5. Potential Medical Issues: If the problem persists, it may be worth consulting a healthcare professional to rule out any underlying conditions such as irritable bowel syndrome (IBS), anal fissures, or other gastrointestinal issues. The fact that you have experienced some skin irritation at the anal area suggests that there may be a need for further evaluation.

6. Over-the-Counter Solutions: In the short term, you might consider using a stool softener or a mild laxative to help ease the passage of stool. However, these should not be used as a long-term solution without consulting a healthcare provider.

7. Anal Care: To address the irritation caused by hard stools, ensure that you are gentle when wiping and consider using a barrier cream to protect the area. If there are persistent fissures, a healthcare provider may recommend specific treatments.

In summary, while your situation may be manageable with dietary and lifestyle adjustments, it’s essential to monitor your symptoms closely. If you continue to experience hard stools or if the irritation worsens, seeking medical advice is advisable to ensure there are no underlying health issues that need to be addressed.

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