Stephen J. Schueler, M.D.

Overview Symptoms Evaluation Treatment enemas fiber lubricant laxatives saline laxatives specialist stimulant laxatives stool softeners suppositories Home Care children dietary fiber enemas laxatives warning signs Prevention Underlying Cause

Hard Stool Treatment

Most episodes of constipation do not last long. Lifestyle changes that can help prevent constipation include a high fiber diet, regular exercise, and increasing fluids in the diet. Treatment for constipation usually requires stool softeners, laxatives, or enemas. Treatment for severe constipation may include manual disimpaction. During manual disimpaction, a doctor uses a lubricated gloved finger to remove hard, dry stool from the rectum.

Treatment for constipation may include:

Hard Stool Enemas

Enemas are normally used to prepare patients for surgery, child delivery, and X-ray examination. But occasionally they are used in cases of constipation. An enema works in two to fifteen minutes. One of the most commonly used is Fleet Enema, which contains sodium phosphate. Mineral oil is another option, as well as a home-made salt water enema.

Enemas must be given carefully, since a misdirected or inadequately lubricated nozzle could damage the anal canal. Most commercial enemas contain phosphate compounds. Overuse in children may lead to toxic levels of phosphorus in the blood. Children should use no more than 1 ounce per 20 pounds of body weight. Pediatric Fleet enemas contain 2.25 ounces, while an adult Fleet contains 4.5 ounces.

Instructions for giving a Fleet enema:

  • Assume a comfortable position, either on the left side with the knees bent. Adults may bend forward at the waist, resting the arms on a firm surface such as a bathroom counter top.
  • Remove the protective shield from the enema tip.
  • Gently insert the enema tip into the anus. K-Y jelly may be used for lubrication. Slight bearing down as if having a bowel movement may help. Do not force the enema tip as this may cause injury.
  • Gently squeeze the bottle until the liquid has entered the rectum.
  • Remove the enema tip.
  • Retain the enema as instructed or for 10-15 minutes if possible.
  • Drink fluids to avoid dehydration.

Hard Stool Fiber

Fiber is often the best choice for simple constipation. Fiber is present in the diet and in supplements. Fiber absorbs water and make stools easier to pass. You must drink additional water for fiber to work properly.

Common laxatives include:

Hard Stool Lubricant Laxatives

Mineral oil and certain plant oils make stools easier to pass by lubrication. Prolonged use of oil laxatives may interfere with the absorption of certain vitamins. Mineral oil should not be taken with meals because it may delay emptying of the stomach. If large doses are taken, it may lubricate the intestine to the point of causing anal leakage.

Hard Stool Saline Laxatives

Saline laxatives are mainly used for cleansing the bowel, in order to prepare for x-rays, tests, or surgery. These products should never be used for long-term treatment. The active ingredient in saline laxatives either magnesium sulfate (Epsom salts) or magnesium citrate. Phillips Milk of Magnesia is a mild saline laxative. These laxatives usually work in about three to five hours.

Hard Stool Specialist

Physicians from the following specialties evaluate and treat this constipation:

Hard Stool Stimulant Laxatives

Stimulant laxatives work by irritating the lining of the intestines. This in turn irritates the nerves that cause the intestinal muscles to move, resulting in a bowel movement.

Laxatives should not be used in anyone who has abdominal pain, nausea, or vomiting. They should not be used for longer than one week of regular treatment.

The ingredient most commonly used in stimulant laxatives is bisacodyl (Dulcolax, Correctol). This form is available in tablets and suppository form. The tablets usually work in six to ten hours. The rectal suppositories work in 15 to 60 minutes.

Phenolphthalein is another stimulant ingredient found in Ex-Lax, Feen-A-Mint Gum, Modane and Alophen. This stimulant usually works in six to eight hours. Aloe, cascara, and senna are stimulants that usually work in eight to twelve hours.

Hard Stool Stool Softeners

Some medications are mainly designed to soften the stools. A common ingredient found in many stool softeners is sodium docusate or calcium docusate (Colace, Correctol Stool Softener, and Surfak). The stool softeners are a popular choice in elderly patients with chronic constipation and hard stools.

Hard Stool Suppositories

Glycerin suppositories work by irritating the lining of the intestines. This in turn irritates the nerves that cause the intestinal muscles to move, resulting in a bowel movement. Glycerin suppositories usually produce results in 15 to 60 minutes.

Continue to Hard Stool Home Care

Last Updated: Jun 6, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Hard Stool References
  1. Bleser S, Brunton S, Carmichael B, Olden K, Rasch R, Steege J. Management of chronic constipation: recommendations from a consensus panel. J Fam Pract. 2005 Aug;54(8):691-8. [16061057]
  2. Brandt LJ, Prather CM, Quigley EM, Schiller LR, Schoenfeld P, Talley NJ. Systematic review on the management of chronic constipation in North America. Am J Gastroenterol. 2005;100 Suppl 1:S5-S21. [16008641]
  3. Clayden G, Keshtgar AS. Management of childhood constipation. Postgrad Med J. 2003 Nov;79(937):616-21. [14654570]
  4. Lembo A, Camilleri M. Chronic constipation. N Engl J Med. 2003 Oct 2;349(14):1360-8. [14523145]
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