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

The act of defecation is the final stage of the digestive process. During it, there is a withdrawal from the body of processed food, not of value to the body, and harmful substances that have got into it from the outside or formed during life activity. All this mass is collectively called feces, which normally has a mushy consistency. While too liquid or hard feces can talk about some disorders in the body.

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

Causes of hard feces

The appearance of hard feces and irregular stools 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 a lot of such reasons. In addition, often there is not one, but several reasons that flow from one another. And the treatment of the disease should be to exclude all possible causes of constipation.

What are the reasons for this, if a person complains that his feces have become hard, like sheep or goats, and defecation is carried out irregularly with large intervals? Consider the possible risk factors for complaints of very hard feces:

• The most common cause of constipation is malnutrition. If there are very few foods in the person's diet that contain soluble and insoluble vegetable fiber (vegetables, fruits, cereals, nuts, bran, etc.), the amount of stool will be less, and the consistency is much denser. Fiber itself has almost no nutritional value, but it absorbs water well, swells and significantly increases the volume of feces, which, respectively, and are output faster, as soon as the brain receives a signal about the overflow of the rectum. And due to water absorbed by food fibers, the stool becomes less hard.
• Psychological reasons that violate the nervous regulation of the act of defecation are also a fairly common cause of stool disorders. It can be about the following situations:
  • Depressive state. Its danger is that in such a state the human body slows down various functions of the body, their nervous regulation decreases. And the intestine is no exception. Its peristalsis is reduced, the chyme slowly moves along the intestine, losing more and more water (actually drying out), and the small amount of food that is caused by apathy and lack of appetite only aggravates the situation, reducing the frequency of defecation.
  • Sexual violence. Coercion to anal sex and painful intercourse can cause an association with it to act as a defecation. Man simply begins to restrain the urge to defecate out of fear to experience pain, which leads to a gradual atrophy of the physiological reflex itself.
  • Identical situation, but are not associated with pain and psychological discomfort, occurs when a person regularly holding back the urge to defecate while at work or in social organizations, because of the awkwardness or certain inconveniences (lack of accessible toilets, public toilets with high attendance etc.).
  • This includes anorexia, which is considered a neuropsychic disorder and manifests itself in the form of pathological fear of excess weight, violation of metabolic processes and control of digestive function. As a result - lack of appetite, rare and difficult acts of defecation.
• Hypodinamy. The introduction of computers into various industries, the popularity of various types of earnings in the network, requiring constant user participation, lead to the fact that this problem of prevalence is increasingly approaching deficiencies in the diet. Insufficiency of physical activity leads to a decrease in motor function of the intestine (peristalsis), which leads to delays in feces in the body and its "drying out". And if we add to this the poor diet for food fiber, very hard feces, which do not go out for several days, become the inevitable consequence of computerization and irrational nutrition.
• Constipation and hard stool can be caused by frequent intake of laxatives. Episodic constipation, which occurs due to short-term disruptions in the body, should be treated for a short time, otherwise the intestine will get used to stimulation from the outside and can not independently remove the stool from the body.
• Sometimes the decline of the reflex occurs because the person specifically restrains defecation because of fear of pain that can be caused by diseases of the anus and rectum (cracks, hemorrhoids, thrombosis, or a recent operation on the rectum).
• Reduce peristalsis, thereby causing constipation and the solid feces may and some medicines: medicine for depression, some of antispasmodics, NSAIDs, anti-ulcer and anti-fungal agents, formulations based on barium salts, drugs used to combat Parkinson's disease and so on. E. Most often, constipation happens when you abuse drugs from diarrhea.
• Negatively affect the work of the intestines, getting into the digestive tract, and some toxic substances, for example lead.

Among other things, hard stool and violation of the defecation regime can cause various diseases, the treatment of which will be the only way to get rid of problems with stool. These are the following pathologies:

• Diseases of the endocrine system and metabolic disorders:
  • The lack of thyroid hormones produced by the thyroid gland (hypothyroidism)
  • Obesity of 1-3 degrees
  • Diabetes
  • The lack of potassium in the body (hypokalemia),
  • Excess of calcium (hypercalcemia),
  • Porphyrin disease with pigmentation disorders, etc.
• Neurological pathologies:
  • Parkinson's disease and its treatment
  • Pathologies of the spinal cord that occur with damage to the centers of innervation of the rectum and anus
  • Disturbance of innervation of the rectum, associated with impaired parasympathetic nervous system
  • Diabetic polyneuropathy
  • Cerebral palsy
  • Multiple sclerosis, etc.
• Diseases of the digestive system:
  • Irritable Bowel Syndrome
  • Tumor processes in the intestine
  • Postoperative stenoses
  • Diverticulum
  • Congenital pathology of the rectum, characterized by its increase in comparison with the norm (megacolon)
  • Expansion of the rectum as a result of frequent constipation (megarectum)
  • Gastritis, duodenitis, peptic ulcer accompanied by antacid drugs, which can provoke constipation, etc.

Hard feces in adults can also be caused by drinking disorders. In a normal person a day should drink at least 1.5-2 liters of fluid. If the water in the chyme is not enough, then the feces will accordingly be denser. Particularly problematic is the situation, when fiber enters the body a lot, in the liquid for its processing a little.

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Hard feces during pregnancy and after childbirth

Quite often, with the problem of hard stool, women experience pregnancy. The reasons for a dense dry stool during this period are also quite numerous:

• increased production of progesterone, relaxing the muscles of the uterus, and at the same time the intestines, as a result of which its peristalsis weakens,
• disruption of the intestine due to squeezing the uterus from day to day,
• negative psychological background due to constant nervousness and fear of sudden termination of pregnancy, abnormalities in the development of the child, etc. (yes unless the pregnant woman on a background of disturbances of a hormonal background and an instinct of motherhood will not find an occasion for pavors and anxiety ?!),
• a pregnant woman, especially on long terms, may in general be wary of pushing herself during the act of defecation because of the fear of labor before the term and restrain the urge to defecate, thereby violating the natural reflex,
• aggravated during pregnancy disease autoimmune, allergic and endocrinological plan,
• hypodynamia on the last days of pregnancy (someone becomes hard to move because of a huge and rather heavy tummy, and others because of the threat of premature birth actively forbids the doctor).

The nature of the causes of hard feces in pregnant women is such that one immediately understands the high prevalence of this problem among women who are waiting for replenishment in the family. But pregnancy is just the beginning. Very often after birth, the problem is not only not resolved, but, on the contrary, is aggravated.

Well, firstly, the restructuring of the body and the restriction in nutrition can impose their imprint on the work of the intestine, a violation of the peristalsis of which by itself will not come back to normal. Secondly, the course of labor can also be different. After a difficult birth with a rupture or a cesarean, a woman may simply be afraid to go to the toilet "for the most part." The reason for this can be fear of divergence of seams, pain from ruptures during straining or appeared during pregnancy due to frequent constipation of hemorrhoids.

An important psychological reason, because of which after the birth of a woman can be observed hard feces and constipation, is a certain discomfort because of the toilet, which can be christened the syndrome of "someone else's pot." Not every person can go to the toilet "in large" in an unusual environment, especially if the cabin is inside a room designed for several people.

Hard feces in a child

Alas, constipation is not a strictly adult problem. Hard feces and problems with bowel movement can be observed in childhood. True, the reasons will be somewhat different:

• Hard feces in the baby are most often caused by eating disorders. For such a strict statement lies the banal transfer of the child to another type of feeding and the incorrect introduction of complementary foods. The digestive system of the baby, accustomed to breast milk, is reconstructed into more dense food gradually, during this period it is possible to observe the compaction of the feces of the baby, and the more rare episodes of bowel movement.

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 to safely empty the bowel. If the mother does not give the baby water between the feedings, she should not be surprised that the baby croaks with hard feces. This leads to a lack of fluid in the body.

Hard feces in a newborn can be a consequence of congenital abnormalities of the intestinal structure, which require observation by a specialist, and sometimes surgical treatment.

• In an older child, hard feces and constipation often result from a small amount of fiber in food, as well as the abuse of food of animal origin (meat and dairy products). Unbalanced nutrition causes the formation of dense stools, which are knocked together, promote the stretching of the colon and reduce its sensitivity (violation of innervation).
• Hard feces in children often occur against the background of drug treatment of a disease. The fact that among the side effects of many medications can be found and constipation, and therefore they have a binding effect, useful for diarrhea, but absolutely not necessary if the child has a normal mushy stool. Under the influence of drugs, the stool becomes denser and removes it from the body now more problematically.

The cause of constipation is sometimes the violation of the intestinal microflora (dysbacteriosis), caused by a course of antibiotic therapy, which ideally should be accompanied by the intake of probiotics. By the way, an adult patient may face similar problems.

• The cause of the appearance of solid feces and problems with its withdrawal can be considered and dehydration of the body, which occurred due to insufficient amount of fluid entering the gastrointestinal tract, active use against this background of foods rich in fiber, prolonged fever and hyperhidrosis. Deficiency of fluid in the body can be a consequence of indigestion or poisoning, accompanied by severe vomiting and diarrhea.
• Violation of the intestinal patency, caused by stool lag and its hardening, is not always a congenital pathology. Sometimes it occurs after swallowing a foreign body creating in the intestine a peculiar cork, or the appearance in the lumen of the intestine or nearby organs of neoplasms from a pathologically expanded tissue.
• There are also psychological factors, but they acquire a somewhat different shade. Problems can arise at a time when the child is accustomed to the pot. For example, a child does not want to croak, but he is put on a potty just in case and asked to tense up. It is clear that the baby such a "game" may not be to taste, and he will specifically restrain the urge to defecate, so as not to sit down on the pot.

Another problem is the beginning of a new life for the child when entering school or kindergarten. The child can be restrained because of congenital shyness, awkwardness before teachers and peers, syndrome of "someone else's pot". Overflow of the rectum, which are compacted during the containment by the calves, leads to a decrease in its sensitivity. The kid does not always notice weak urges "by and large," empties the bowels less often, which means that his stool becomes harder and more dry.

Whatever it was, and parents need to closely monitor the nature of the feces of the child and the frequency of bowel movement. If the child is often restrained, and his intestine loses its former sensitivity, it will become the beginning of intoxication of the child's body with harmful substances contained in stool, due to the development of chronic constipation.

Pathogenesis

We will not delve into all the subtleties of the digestive process, but we will dwell on the moment when the food (chyme) that is sufficiently crushed and prepared for assimilation enters the intestine: first a thin one about 6 meters in length, and then a 1.5-meter large intestine. To ensure that the small intestine can fit in the abdominal cavity, it is located in the form of loops. With the help of special equipment you can see that the loops of the intestine are in constant motion. This is because the walls of the bowel are forced to contract all the time, mixing food and pushing it to the entrance to the large intestine.

The process of moving food through the intestines is called peristalsis. All the way from the duodenum to the entrance to the large intestine the chyme passes for 6-7 hours, considerably decreasing in size. After all, valuable nutrients in the small intestine by the movement of special villi, covering its inner shell, are absorbed into the blood.

The rest of the chyme, along with water, enters the large intestine curved in the form of the letter "P" and has 6 parts in it, where the fluid is absorbed, the fiber is split and the feces are formed directly.

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

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

To ensure that the chyme, and then the feces formed from it, move along the intestine for no more than a day (ideally, the act of defecation should be performed daily), a person should consume a sufficient amount of food and liquids. The speed of movement and the consistency of feces depend on the intestinal peristalsis.

Violation of the contractile function of the intestinal walls leads to the fact that the chyme mixes poorly, gets confused and lingers in the rectum for 2 or more days. During this time the feces completely dehydrated and compacted, which subsequently causes difficulties with its removal from the body. In fact, unlike pulverized solid feces, knocked down into a large lump or separate balls, it is much more difficult to pass through the anus, whose diameter is almost half that of the initial (proximal or duodenal) portion of the large intestine.

This problem has its name - constipation. According to statistics, in the world about constipation is affected by 10 to 50% of the world's population. At the same time, the older a person becomes, the more likely the development of constipation. People who crossed the threshold of 55 years are more likely to be constipated. The risk group also includes children, including infants, young women, pregnant and lactating mothers.

Such a large discrepancy in statistical results is due to the difference in food preferences and traditions, and also by the fact that not all people hurry to consult doctors with such a delicate problem, the reasons of which can be a great many. But in most cases the problem of solid feces is solved elementary with the help of changes in lifestyle and food preferences. But there is a certain percentage of situations where constipation is a symptom of more serious pathologies requiring appropriate treatment.

What is hard feces?

Normally, the evacuation of the intestine should occur if not every day, then at least once in 2 days. If this does not happen, we are talking about constipation, in which the stool masses, as a rule, have a dense consistency and do not allow themselves to be "kicked out" without noticeable straining.

There are acute and chronic constipation. The latter is said if the emptying of the intestine occurs irregularly for more than 3 consecutive months and is accompanied by a certain discomfort and pain due to high fecal density.

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

• deterioration of appetite,
• nausea due to the entry into the body of toxic substances contained in stool and for a long time remaining in the body,
• chronic fatigue and fatigue,
• deterioration of complexion, appearance of various purulent eruptions on the skin.

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

Sometimes there are false desires for defecation, which can result in the escape of gases. Such desires are quite painful, because the gases even more stretch the intestines, trying to "squeeze" between dense clusters of feces. Most often, such a painful separation of gases takes place if the hard feces looks like balls, closely adjacent to each other.

Symptoms of hard feces can also be considered difficulty in removing it with intense urge and a prolonged absence of productive urge to defecate. The appearance of the stool may also be slightly different. In one case, you can see a thick dense "sausage", which hardly passes through the anus, in the other - a few stuck together formless elements, in the third - very hard feces, consisting of balls resembling the feces of goats or sheep.

Hard feces are extensible, and any doctor will tell you about it. At its core, hardened in the intestines, stools 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 the variety of its causes.

One of these types of constipation is hard feces with balls. About such feces most often say: hard sheep or "goat balls." Individual lumps of fecal matter in this case have small dimensions (up to 1-2 cm).

According to doctors, such a stool is unfairly called a full-blown disease. It is rather a functional disorder, the most common causes of which are dysbacteriosis and irritable bowel syndrome ("lazy" intestine).

Symptoms of this disorder are often: episodes of severe weakness, painful bloating due to excessive accumulation of gases, increased blood pressure, attacks of headaches.

Hard pellets in the feces of an adult can talk about violations of the digestive tract, as a result of which food is poorly digested. Microscopic solid "stones" can be found in feces and in cholelithiasis, because small concretions from the gall bladder are excreted naturally or after ultrasound treatment through the intestine along with feces.

Small and hard white or light yellow grains of the mother often find in feces of infants, especially those who are breastfed. In this case, it is not necessary to seek pathology. Such feces is considered the norm and, most likely, it says that the mother has fatty milk.

White solid feces also do not always talk about the disease. The main pigment of feces - stercobilin - gives them a brown tint. However, the color of feces largely depends on the food we eat. White color excrement can impart dairy products. If the diet consists mainly of them and plant foods, the feces will be very light, almost white. And if, in addition, people eat few foods that contain fiber, they will not have enough feces, they will be less likely to leave and become quite hard.

Discoloration of the stool becomes a common symptom of cholelithiasis, when blockage of the bile ducts occurs by concrements. The reason for this change in the color of the feces is in the absence of the pigment of sterocilin. An identical situation can be observed with inflammatory lesions of the liver (for example, with acute hepatitis), inflammation of the bile duct (angiocholitis) or pancreas (acute pancreatitis), dysbiosis, viral pathologies. The cal in this case acquires a light gray or a dirty white color.

Suspicious may seem too dark and hard feces. But before you panic, you need to understand what you eat the day before and what medicines you took. Some foods (vinaigrette, dark grapes, prunes, blueberries, black currants) are able to change the color of the feces to a darker color for 3 days. Having eaten a large number of the above described delicacies, you can get almost black feces, and if there is a violation of the intestinal motility it will also be solid, usually in the form of balls.

Make the feces dark and even black can and medications. These are iron preparations prescribed for anemia, activated carbon and gastric drugs based on bismuth (for example, the advertised "De-Nol"). This side effect of drugs, however, is not a reason for their withdrawal.

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

But if the feces are hard, but not black, but the usual color with blood, it is about bleeding in one of the departments of the rectum. With constipation due to difficulties with the removal of feces of solid consistency, the anal opening undergoes a strong tension, but since it has a limited diameter, it is likely that cracks can form directly in the anus wall.

This, of course, is the lesser of evils, because feces and blood are also observed with hemorrhoids and cancers of the stomach and intestines.

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

Vivid green feces are among vegetarians who consume a large number of products of this color. Green feces can attach to some vitamin-mineral complexes, natural laxatives, kelp, iodine preparations, sorbitol.

Among the pathological causes of green feces can be identified: infection with parasites (lamblia, salmonella), food intoxication or allergies, viral pathologies, the presence of unchanged bilirubin in the stool, Crohn's disease, stomach ulcer and DPC, diabetes, thyrotoxicosis, too rapid passage of bile through the gastrointestinal tract, etc. .

By the way, in newborns such feces are considered the norm. During the first month of life, the feces of the child have a greenish color, and only then it begins to change. And if the child does not receive enough fluid, 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 mixture, intolerance to milk protein. Among the pathological causes can be identified dysbiosis and disruption of the liver and gallbladder.

Yellow solid feces can be observed in people who have problems in the form of impaired motor skills and digestion in the small intestine. If the feces have a light yellow color, the cause is most likely in pancreatic diseases, less often - the liver or gall bladder. Sometimes yellow color in feces is an indicator of increased fermentation in the intestine or the predominance of dairy products in the diet.

If the stool is not only solid, but also dry (as if dried up), the reason lies either in the lack of fluid, or in the violation of the formation of stool due to malfunctions in the gallbladder or intestinal motility disorder.

So far we have talked about the types of hard feces and situations where feces during constipation contain bloody or hard sandy blotches. But sometimes hard feces can stand out together with mucus. What does such a symptom say, in fact, in an ideal visual mucus in the feces should not be determined?

First you need to figure out where the mucus came from. For example, in inflammatory pathologies of the upper respiratory tract, mucus can simply swallow and enter the intestine where it mixes with feces. In the intestine, the outgrowth of mucus may be triggered by pinion products (for example, bananas, cottage cheese, oat flakes porridge, watermelon). At maternal age, mucus in the stool is considered an indicator of insufficient maturity of the digestive system.

However, in some cases, mucus in the stool can also indicate the development of various diseases: inflammation in the small or large intestine, tumor processes in the lower gastrointestinal tract, hemorrhoids, dysbacteriosis, irritable bowel syndrome, intestinal infections, cystic fibrosis and some other pathologies. Slime also appears in the event that the absorption of various nutrients is broken: fat, lactose, etc.

Constipation with hard stubborn feces is a nuisance. 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 cases, the urge to defecate is strong and painful, and even after defecation, there is some discomfort.

The reason for this "misunderstanding" can be considered reduced acidity of gastric juice and a lack of bile flow into the intestine. A similar phenomenon, called the stool-like stool, can also be observed with irritable bowel syndrome accompanied by constipation. In this case, the appearance in the faeces of mucus is not excluded.

Consequences and complications

Hard feces in any of its manifestations are considered the most likely cause of constipation. In itself, a short-term constipation is unlikely to bring much harm to a person. Unless a certain discomfort, pain and a certain chance at some point to get a painful cracks in the anus.

Other things are long dysfunction with feces or chronic constipation. Here the list of complications is much greater: hemorrhoids, colitis and reflux enteritis (inflammation of the small intestine), proctosigmoiditis (inflammation of the distal parts of the large intestine), paraproctitis (inflammation of the tissues in the anal anus), megacolon (enlargement or simply enlargement of the large intestine). The consequences of the megacolon become even more severe and frequent constipation.

It must be remembered that along with feces, harmful substances and toxins are emitted from the body. If the feces have a solid consistency, due to which it is more difficult to move along the intestine and stay in it for a long time, the toxins from the stool gradually go into the blood, poisoning the whole organism.

Stagnation of fecal masses in the intestines promotes the accumulation of carcinogenic substances in it in the form of products of the vital activity of the intestinal microflora. And carcinogens in turn contribute to the development of cancerous processes of a malignant nature. Thus, chronic constipation, in which many of us do not see danger, can cause cancer of the large intestine or part of it - the rectum. So joking with constipation is not worth it. It is necessary to do everything that solid feces have acquired a normal consistency and the intestine could have it in time and without much difficulty to remove from the body.

[2], [3], [4], [5], [6], [7],

Diagnostics

When a person comes to the reception with complaints about hard feces and painful embarrassing bowel movements, the doctor immediately raises the question: how long did this symptom appear and whether it is related to food 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 suggestive questions, the doctor proceeds to study the patient's medical history on the medical chart, specifies whether there have been cases of constipation in close relatives, is determined with a preliminary diagnosis (acute or chronic constipation).

Chronic constipation is said if the patient positively respond to at least 2 questions, and the described symptoms should be observed for at least 3 months in a row (if the constipation took place not permanently, then for half a year):

• Defecation occurs less than 3 times a week,
• solid whole or "sheep" feces takes place not less than in 25 percent of defecations,
• there is a strong rectal tension during defecation (more than 25 percent of cases),
• in a quarter or more episodes of defecation there was a feeling that the intestine was not completely emptied,
• in some cases, a hard stool to empty the bowels was handled.

The doctor will ask you to describe the nature of the chair: color, smell, consistency, shape. If the therapist sends for consultation to the proctologist, he will without fail perform a rectal rectal examination of the rectum. The procedure is, of course, unpleasant, but necessary in the pathologies of the large intestine.

To treat constipation without finding out its cause is like poking your finger into the sky. And since the cause of hard feces as a symptom of constipation can be a great many, and many of them pathological, without the analysis of excrement can not do.

What kind of tests can be prescribed for constipation:

• a general blood test (usually in most cases to clarify the condition of the patient's body and diagnose inflammation);
• fecal analysis for the detection of hidden blood,
• study of feces on the microflora (bakpos),
• coprogram (detailed analysis of faeces).

If a tumor is suspected, a biopsy of the large intestine mucosa is performed, a cytological and histological examination of the biopsy specimen is performed. Laboratory tests can be designed to detect abnormalities in the secretory organs of the digestive system.

Instrumental diagnosis of chronic constipation includes:

• Radiography of the pelvic organs, which allows to assess the functional state of the colon, its peristalsis, dimensions, as well as birth defects, strictures and other anomalies,
• irrigoscopy (contrast radiography),
• colonoscopy (endoscopic examination of the large intestine),
• capsular endoscopy (instead of an endoscope, a capsule with a built-in mini camera is used in the procedure, which is swallowed like a tablet and is removed naturally after 8-9 hours, during which time the camera continuously records)
• a computer tomogram of the large intestine (it can be called a virtual colonoscopy).

[8], [9], [10], [11], [12], [13], [14]

Differential diagnostics

Differential diagnosis in the case of hard feces enables the physician to differentiate pathological causes from physiological and psychological. If the analysis and instrumental examination does not reveal any deviations, the doctor prescribes additional studies that help to determine the dependence of an unpleasant symptom on the psychoemotional state of the patient or his hormonal background, taking medications, including laxatives, or a lifestyle.

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Treatment of constipation with hard feces

Many patients, finding instead of the usual feces in the form of sausages, "sheep balls" panic, not understanding the cause of this change in appearance and characteristics of the stool. Not knowing what to do, if the stool is solid and causes a lot of unpleasant sensations during the defecation (and even fear), 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 do not have to risk taking self-medication. Constipation is not a normal state of the body, and therefore requires a certain treatment. Assigning laxatives and enemas can only exacerbate the situation, because a banal constipation may hide a more serious problem.

Doctors to treat constipation with a hard stool approach quite seriously. Therapy of this disorder of the stool is carried out in a complex way and includes:

• Correction of lifestyle (from hypodynamia to active), revision of medications taken in favor of those drugs that do not cause constipation, an increase in the daily volume of liquid (at least 2 liters) and fiber in the diet of patients (at least 35 g per day).
• Reception of soft laxatives:

• swelling action that contribute to water retention and increase of stool in the volume (Mukofalk, Polycarbophil, Methylcellulose, etc.)
• osmotic, which try to draw water into the intestine and increase its volume in the stool, thereby softening the hard stools (Macrogol, Sorbitol, Mannitol, Dufalac, salt laxatives, represented by sulfate or magnesium hydroxide, phosphate or sulfate sodium, etc.),
• lubricants in the form of rectal suppositories on the basis of glycerin or vaseline oil (facilitate passage of feces through the intestine).

Physiotherapy treatment : electrotherapy (abdominal faradization), low-power direct current (galvanization), UV irradiation, paraffin applications on the pelvic area, heating the stomach with electric current (diathermy), electrophoresis with spasmolytic, various thermal and massage procedures.

• The purpose of stimulating laxatives (Bisacodyl, castor oil, Senadixin, etc.), prokinetics (Domperidon, Metoclopromide, etc.), spasmolytic drugs (Niaspam, Dicetel, Mebererin, etc.) .

Cleansing of the intestines with enemas (prescribe if the effect of taking laxatives is insufficient).

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

In addition, a physician can be prescribed vitamin therapy. With constipation, vitamins  A, C and B1 are useful  , which improve digestion and innervation of the intestine. The above vitamins can enter the body together with food products or in the form of pharmaceutical products.

Surgical treatment for constipation with hard feces is shown only in cases of ineffectiveness of conservative therapy, with congenital anomalies or malignant tumors in the digestive tract.

Solid feces and laxatives

Consider how using laxatives can solve the problem of hard feces and painful irregular stools.

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

The medicine is given in the form of a powder, which is placed in single sachets. Take a laxative should be 1 sachet per reception. Multiplicity of admission can reach 6 times a day. Before use, the powder from the sachet is mixed with cold boiled water in an amount of 150 ml. During the treatment, a lot of water is drunk (from 2 liters and more).

Contraindications to the use of the drug are: an intestinal obstruction or a high probability of pathology, abnormalities in the structure of the intestine, a violation of the water-electrolyte balance, a severe form of diabetes mellitus. In pediatrics apply from 12 years.

Among the side effects of "Mukofalka" can be identified: allergic manifestations, a temporary increase in gassing, a feeling of fullness of the intestine.

"Macrogol" is a preparation based on the ethylene glycol polyhydric alcohol polymer, which forms hydrogen bonds with water particles. In the gastrointestinal tract, macrogol binds the water and transfers it to the chyme, and then to the stool, thereby diluting the stool masses. In parallel, it stimulates intestinal motility and prevents the exit of electrolytes with feces.

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

Take the drug only once a day in the amount of 1-2 bags, the contents of which are poured into ½ cup of water. They drink medicine in the morning, on an empty stomach. The result is noticeable on day 2-3.

Do not prescribe the drug to patients with ulcers and erosions inside the intestine, ulcerative colitis, Crohn's disease, toxic expansion of the large intestine, with full or partial intestinal obstruction, with abdominal pains arising for unknown reason. Contraindicated taking the drug with hypersensitivity to its components. In pediatrics apply since 8 years. Caution is observed in case of heart failure and a state of dehydration.

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

"Dufalac" is a syrup based on lactulose with a hyperosmotic effect. Among its effects, stimulation of intestinal peristalsis and an improvement in the absorption of phosphates and calcium salts are distinguished.

It is used to regulate the rhythm of emptying the large intestine and softening hard feces. Has the form of release in the form of sachets with powder.

The drug mono taken in its pure form or diluted with water. In the mouth, the medicine is not delayed, swallowing immediately. The dosage is chosen by the attending physician (usually from 15 to 45 ml). Children's dose - 5-15 ml. Depending on the age. Multiplicity of administration 1-2 times a day.

Drugs in powder form adults take 1-3 packets a day, diluting in water.

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

Do not prescribe a laxative for galactosemia, obstruction or perforation of the stomach or intestines, intolerance to galactose and fructose and deficiency of lactase, hypersensitivity to the components of the drug.

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

"Senadixin" is a herbal preparation of stimulating action. Has a quick effect (within 6-12 hours). The active substance of the drug - the leaves of Senna - has an irritant effect on the intestinal receptors, thereby stimulating its reduction (motility). In parallel, it has an osmotic effect, attracting water and diluting the stool masses. Strengthens the pressure of feces on the walls of the intestine, thereby stimulating peristalsis.

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

Take the drug 1-2 tablets 1-2 times a day, but not more than 4 tablets per day.

Contraindications to the appointment of a laxative are: individual intolerance of the components of the medicine, Crohn's disease, intestinal obstruction, ulcerative colitis, bleeding from the digestive tract, uterine bleeding. Do not prescribe medicine for acute appendicitis and other pathologies of the intestine at the stage of exacerbation, peritonitis, peptic ulcer, cystitis, disturbance of water-electrolyte balance, spastic constipation, strangulated hernia, bleeding from the anus. Pediatrics are allowed to use the drug from the age of 12.

Side effects in "Senadexin" are very rare in the form of light allergic reactions, changes in urine color, abdominal pain and diarrhea, muscle weakness and heart failure as a result of loss of electrolytes (prolonged use of large doses).

Alternative treatment

As we already mentioned, not everyone is in a hurry to go to the doctor with a problem of hard feces. Someone is uncomfortable in discussing such a sensitive issue, others are afraid of numerous and far from the most pleasant examinations, the third simply does not have the opportunity to use the services of doctors. But the problem remains and requires an early resolution, while against the background of chronic constipation did not develop other dangerous pathologies.

For those who are wondering how to soften hard stool without medical intervention and do no harm to their health, several recipes of alternative medicine can be advised. However, it must be remembered that none of the drugs in the alternative treatment can be used if the cause of hardening and irregularity of the stool is a certain obstruction in the intestine that inhibits the movement of stool in the intestines (gut flushes, swelling in the intestine, adhesions, lumps of undigested food, foreign body in the digestive tract, anomalies in the development of the body, spasms).

In some sources, one can meet a recommendation to soften the stool with an enema with soapy water. Despite the fact that the effect of this procedure comes in a short time (within 10-15 minutes), doctors are not advised to rush with such a cardinal remedy. For a start, you can try to include in your diet crushed seeds of flax and bran. You can eat them as part of the usual dishes, adding 1-2 tsp. Per serving. Do it better in the morning and afternoon, so that it was possible to dilute the alternative "medicine" in the stomach and intestines with a lot of water (2-2.5 liters per day).

Increases the amount of feces and softens the consistency of the dining room and the beetroot. It can be eaten both raw and cooked. A good effect also has beet juice, which must be drunk between meals three times a day. For if you need to drink at least a glass of juice. Freshly prepared juice must be left standing for one hour before use.

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

Alternative healers believe that a cucumber pickle helps quickly and effectively solve the problem of solid feces . It is not a marinade, but a brine, which consists of water and salt with the addition of spices (eg dill). Brine should drink every day for 1-2 glasses. The warmed cabbage pickle also has the same effect.

To facilitate the emptying of the intestine can be with the help of vegetable oils. Suitable are any oils that are at home in the kitchen: sunflower, olive, corn. At a time you need to drink 1-2 tablespoons. Oil. Repeat the reception of oils 3-4 times a day. If the pure form of swallowing oil does not work, it is added to food.

Treatment with herbs is also considered effective for constipation. Take, for example, the same fennel. Its seeds, like the seeds of cumin, are able not only to solve the problem of increased gas production, but also to normalize the stool. To this end, prepare an infusion of 1 spoon of seeds and 1.5 cups of boiling water (insist for 30-40 minutes), filter and squeeze the seeds. The composition is divided into 4 parts, which are used in breaks between meals.

Among the other recipes for constipation is: infusion of nettle (1 spoonful per glass of water) or oregano (2 tablespoons per glass of water), a decoction of seeds and infusion of burdock roots (1 spoonful per glass of water), boiled water boiled Senna (1 spoonful by 3/4) glass of water).

No matter how effective alternative recipes are, but if constipation is caused by intestinal atony without normalizing the way of life and nutrition, getting rid of it is impossible.

[16], [17], [18], [19], [20], [21]

Homeopathy

A sufficient set of funds that help those with hard stool and permanent constipation own not only traditional and alternative medicine, but also homeopathy. Homeopathic medicines have a minimal amount of contraindications and side effects, which means, with the correct approach to their use, you can get rid of constipation quickly and safely.

Medicines homeopathy can have a different effect, each in its own way, normalizing the person's chair, so they should be appointed by a specialist who is familiar with the mechanism of action of drugs.

Homeopathic preparation Sulfur positively affects the work of the lazy intestine, improving the gated (abdominal) blood circulation.

Nux vomica medicine helps to relieve spasms if hard feces appear as a result of irregular defecations. And in the toilet "for the most" people can not go because of spasmodic contraction of the anal sphincter at the time of defecation.

A homeopathic remedy based on horse chestnut (Aesculus hippocastanum) will help with constipation against the background of hemorrhoids and cracks in the rectum.

Anacardium will be useful in both atonic and spastic constipation, it also helps to remove the unpleasant sensations associated with eating (nausea, indigestion, abdominal pain).

If the cause of constipation is insufficient intake of bile in the intestine during the entry of chyme there, Lycopodium will help to increase the outflow of bile. It is effective in case of "sheep" feces. However, like Tuy.

If the hard feces goes along with the mucus, and especially if there are cracks in the anus, Grafitis will be useful. With its help, diarrhea is treated by prescribing other dosages.

To improve the tone and motility of the rectum, prescribe homeopathic remedies: Sepia, Silicea, Opium, Barium carbonicum. The last two drugs are especially often used in the treatment of atopic constipation in elderly people.

Which of the described drugs will be effective in each case, the doctor decides the homeopath, given the many nuances incomprehensible to the uninitiated reader. He also determines in what dosage and at what time drugs for constipation should be taken.

Prevention

Is this not the reason to do preventive maintenance and timely treatment of constipation. But it is not so difficult to prevent constipation if it is not a question of tumors, abnormalities of the structure or foreign bodies in the intestine. A balanced diet with a sufficient amount of plant fiber and drinking water in volumes of 1.5-2.5 liters will not only help to avoid constipation and hard stool, but also have a positive effect on the health and skin condition.

It can help prevent chronic stool disorders and timely treatment to the doctor regarding emerging diseases of the digestive, endocrine and nervous systems. Constipation is usually already a late consequence of such pathologies. If the disease is captured and treated at an early stage, serious violations of defecation may not occur.

An important role is played also by the person's way of life. Hypodinamy often becomes the cause of many diseases, and constipation is no exception. Peristalsis of the intestine decreases as the physical activity of its host decreases. Therefore, people engaged in intellectual work, breaks are better not to spend in the smoking room, and in the gym or at the stadium. Yes, and eat working people need to fully in the dining room or cafe, and not save snacks (crisps, chips, buns, fast food), because of which the problem of constipation and hard stools has become particularly relevant.

Forecast

How much discomfort the hard feces would not bring, in fact, the situation is not at all hopeless. In most cases, even do not have to resort to serious treatment, limiting the increase in the amount of fiber in the diet and increased physical activity.

If diet and lifestyle changes do not help, go to the drug treatment. In order to fight with constipation was carried out effectively and had a lasting result it is important to follow the doctor's advice in choosing the kind of laxative. Do not immediately resort to stimulants that are addictive. Long-term use of such medications can only exacerbate the situation when the intestines become simply too lazy to empty themselves.

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

The worst prognosis we have in neglected cases, when constipation 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 operational. At 4 stages of the disease people live no more than 3 years.

[22], [23]