"Is this constipation?" We explain the causes and treatments for symptoms where you only pass hard, pellet-like stools.

[Column] "Is this constipation?" Explanation of the causes and treatments for symptoms where only hard, pellet-like stools are passed.

Hard, dark, pellet-like stools. If you only pass these kinds of stools, your stomach won't feel completely empty every day, and you might wonder, "Is this constipation?" In fact, in many cases, these pellet-like stools are caused by lifestyle habits.
This time, we'll explain the basics of constipation and introduce lifestyle habits that can help relieve hard, lumpy stools.

I only have small, hard stools every day... Does this mean I'm constipated?

What is hard, lumpy stool? An explanation of its symptoms and characteristics.

What is hard, lumpy stool? An explanation of its symptoms and characteristics.

Feces that are round and pellet-shaped, like rabbit droppings, are generally called "pellet feces." They are characterized by being small, black pellets and hard.

People who only pass hard, lumpy stools are more common among women and the elderly. They often feel like they haven't completely emptied their bowels even after a bowel movement, leading to the complaint of "not feeling completely relieved." Also, because hard stools can cause problems such as anal pain or anal fissures when straining during a bowel movement.

Causes of persistent hard, lumpy stools

What's the difference between healthy stool and hard, lumpy stool?

What's the difference between healthy stool and hard, lumpy stool?

Healthy stool is banana-shaped. It has just the right amount of moisture and softness, making it smooth and easy to pass with just a little straining. It's the ideal stool, leaving you with a refreshing feeling of having completely emptied your bowels.

On the other hand, with hard, pellet-like stools, small, hard pellets are passed in short bursts. When stool remains in the large intestine for a long time without being passed, the water in the stool is absorbed by the large intestine, resulting in hard, pellet-like, short stools.

What causes lumpy, hard stools?

What causes lumpy, hard stools?

One of the causes of hard, lumpy stools is constipation. The Japanese Society of Internal Medicine's 2017 Guidelines for the Treatment of Chronic Constipation defines constipation as "a condition in which a sufficient amount of stool that should be expelled from the body cannot be comfortably eliminated."

Therefore, even if you don't have a bowel movement every day, if you are able to have a comfortable bowel movement with a sufficient amount of stool, it is not considered constipation. However, if you only have hard, lumpy stools and feel like you haven't completely emptied your bowels or experience discomfort, then it can be considered constipation.

Chronic Constipation Treatment Guidelines 2017 | Journal of the Japanese Society of Internal Medicine, Vol. 109, No. 2

Constipation can be classified into several types, and some types tend to produce hard, lumpy stools, so caution is necessary. The following section will explain the types of constipation and the types of stool they produce.

A thorough explanation of the basics of constipation! What are the different types of constipation and stool shapes?

kinds
  • habitual constipation

    habitual constipation

    Habitual constipation is constipation caused by lifestyle habits. If you are in a hurry every morning and don't have time to sit on the toilet properly, ignoring your urge to defecate, or skipping breakfast, you may develop habitual constipation.
    Be careful not to hold back your bowel movements, as this weakens your defecation reflex and makes it harder to feel the urge to go. Also, skipping breakfast means you won't get enough fiber and water from your meals. In either case, stool tends to stay in the large intestine longer, resulting in dry, fragmented stools.

  • Atonic constipation

    Atonic constipation

    Atonic constipation is a condition in which the large intestine relaxes, weakening peristalsis and making it difficult to pass stool. It is commonly seen in postpartum women and the elderly.
    If you lack sufficient abdominal muscle strength and cannot generate enough abdominal pressure even when straining during bowel movements, you are prone to atonic constipation. In cases of atonic constipation, the stool loses moisture and becomes hard.

  • spasmodic constipation

    spasmodic constipation

    Spastic constipation is a type of constipation caused by irregular peristaltic movements of the large intestine due to stress or an imbalance in the autonomic nervous system. A characteristic of spastic constipation is that the stool tends to be hard and pellet-like, resembling rabbit droppings.
    When the large intestine becomes tense and spasms occur, the intestinal tract in the spasmed area narrows, hindering the passage of stool and resulting in hard, lumpy stools. Spastic constipation can sometimes be caused by a condition called "irritable bowel syndrome," so if you are concerned, you should consult a medical professional.

How to fix hard, lumpy stools! Recommended methods to relieve constipation.

countermeasure
  • Drink water first thing in the morning! Proper hydration prevents constipation.

    Drink water first thing in the morning! Proper hydration prevents constipation.

    Staying hydrated is crucial for resolving the problem of hard, lumpy stools. Dehydration can easily lead to hardened stools and worsen constipation, so be careful. Drinking a glass of water upon waking is recommended, as it stimulates the digestive system and improves bowel movements.
    The Ministry of Health, Labour and Welfare's "Drink Water for Your Health" campaign recommends consuming 1.2 liters of water per day from drinking water. To prevent health problems and accidents caused by dehydration, it is recommended to hydrate before going to bed, upon waking up, and before and after bathing. Drink water frequently to prevent hard, lumpy stools.

    "Drink Water for Your Health" Promotion Campaign | Ministry of Health, Labour and Welfare

  • Avoid excessive caffeine and alcohol intake.

    Avoid excessive caffeine and alcohol intake.

    While you should actively drink fluids to prevent hard, lumpy stools, it's recommended to limit your intake of caffeine and alcoholic beverages. This is because caffeine and alcohol have a diuretic effect, and excessive consumption can increase urine output.
    Increased urine output can lead to dehydration, and water is more easily lost from the stool in the large intestine. Therefore, when consuming caffeine or alcohol, it's a good idea to consciously replenish fluids with caffeine-free and alcohol-free beverages as well.

  • Don't ignore the urge to go to the toilet! Make it a habit to go to the toilet in the morning.

    Don't ignore the urge to go to the toilet! Make it a habit to go to the toilet in the morning.

    Going to the toilet without holding it in when you feel the urge to defecate can also be a way to alleviate hard, lumpy stools. In particular, after breakfast, the large intestine becomes more active due to the stimulation of food entering the stomach, making you more likely to feel the urge to defecate.
    If you suppress your urge to defecate due to reasons such as being too busy to find the time, your defecation reflex will weaken, making it harder to feel the urge to defecate and potentially leading to constipation. Be careful about this. Also, even if you don't feel the urge, setting aside time each day to sit on the toilet for a while can help establish a regular bowel movement rhythm and is effective.

  • Get plenty of dietary fiber in your daily meals.

    Get plenty of dietary fiber in your daily meals.

    If you're having trouble having a bowel movement, check your diet to see if you're lacking in dietary fiber. Dietary fiber is a food component that reaches the large intestine without being digested or absorbed, and is effective in preventing constipation.
    Dietary fiber is classified into two types: soluble and insoluble. Soluble dietary fiber, which is abundant in konjac, seaweed, and barley, helps to soften stools.
    On the other hand, insoluble dietary fiber is said to stimulate the large intestine and promote bowel movements, and is abundant in burdock root and wheat bran. In spastic constipation, which is one of the causes of hard, lumpy stools, consuming too much insoluble dietary fiber can sometimes irritate the stomach too much, so it is a good idea to consciously consume soluble dietary fiber.

  • Eat three balanced meals a day.

    Eat three balanced meals a day.

    Eating three proper meals a day, without skipping breakfast, is a fundamental way to improve constipation. If you're not passing enough stool, you might be eating too little.
    Stool is the residue left after absorbing nutrients and water from food, so if you eat less to begin with, the volume of your stool will decrease.
    Furthermore, insufficient intake of dietary fiber and fluids from food can worsen constipation. Eating three balanced meals in appropriate amounts each day is effective in improving bowel movements.

  • Let's eat foods containing lactic acid bacteria and bifidobacteria.

    Let's eat foods containing lactic acid bacteria and bifidobacteria.

    Beneficial bacteria such as lactic acid bacteria and bifidobacteria play an important role in maintaining gut health by improving the intestinal environment. People who have poor bowel movements and only pass hard, lumpy stools should increase their opportunities to consume beneficial bacteria through their diet.
    Human gut bacteria are broadly classified into three types: beneficial bacteria, harmful bacteria, and neutral bacteria. In a healthy gut, beneficial bacteria are dominant. On the other hand, people who are prone to constipation or who lead irregular lifestyles are said to have a higher proportion of harmful bacteria.
    Beneficial bacteria are abundant in yogurt, lactic acid bacteria drinks, and fermented foods, so make a conscious effort to eat them to improve your gut environment.

  • Support your gut bacteria by taking oligosaccharides!

    Support your gut bacteria by taking oligosaccharides!

    One way to increase beneficial bacteria in the large intestine is to consume oligosaccharides. Oligosaccharides are said to act as food for beneficial bacteria in the large intestine, thus increasing their numbers. They are abundant in soybeans, onions, and bananas, so those who are concerned about hard, lumpy stools should actively incorporate them into their diet.
    Additionally, there are foods for specified health uses that contain oligosaccharides, making them easy to incorporate into your diet. However, consuming large amounts may cause loose stools, so it's important to stick to the recommended daily intake.

  • Make exercise a habit to improve bowel function.

    Make exercise a habit to improve bowel function.

    Exercise is also important for improving constipation and hard, lumpy stools. Regular exercise helps regulate the balance of the autonomic nervous system, which can support proper peristalsis in the large intestine.
    Furthermore, consistent exercise strengthens your abdominal muscles, allowing you to apply sufficient abdominal pressure to push out stool during bowel movements. If you're aiming for regular bowel movements, try incorporating exercise into your routine.

  • Massage your stomach to help with bowel movements!

    Massage your stomach to help with bowel movements!

    If you're struggling with hard, lumpy stools, incorporating abdominal massage into your daily routine is a good idea. The key is to gently stimulate your abdomen with light, stroking motions.
    Placing both hands on your stomach and stroking in a clockwise direction, as if drawing the Japanese character "no," is recommended because it massages along the flow of the large intestine.

  • Let's relieve stress and regulate our autonomic nervous system.

    Let's relieve stress and regulate our autonomic nervous system.

    To improve hard, lumpy stools, consider whether you're experiencing excessive stress or fatigue. The autonomic nervous system consists of the sympathetic nervous system, which is dominant during activity, and the parasympathetic nervous system, which is dominant during rest. These two systems work together to regulate bodily functions.
    However, stress can disrupt the balance of the autonomic nervous system, which may affect the function of the large intestine.
    Furthermore, the peristaltic movement of the large intestine is mainly regulated by the parasympathetic nervous system, and when you are stressed and tense, the function of the parasympathetic nervous system weakens, which can lead to constipation. Therefore, regulating the autonomic nervous system and effectively relieving stress is one way to deal with hard, lumpy stools.

    To live a less stressful life

What to do if your constipation persists even after reviewing your lifestyle habits

If your stool doesn't improve, consult a medical professional.

If your stool doesn't improve, consult a medical professional.

If you've reviewed your lifestyle habits but your symptoms haven't improved and you continue to experience hard, lumpy stools every day, you should consult a medical professional. If a condition such as irritable bowel syndrome is causing the hard, lumpy stools, simply paying attention to your lifestyle habits won't be enough to address the problem.

It's important not to keep your stomach problems to yourself, but to tell a doctor about your symptoms at a gastroenterology, general internal medicine, or gastrointestinal clinic.

What diseases can cause hard, lumpy stools?

What diseases can cause hard, lumpy stools?

Diseases that may be associated with hard, lumpy stools include irritable bowel syndrome (IBS) and colon cancer. IBS is a condition in which symptoms such as constipation, diarrhea, and abdominal pain occur even though there is no inflammation or abnormality in the intestines.
It is said that irritable bowel syndrome (IBS) can develop when the visceral nerves become hypersensitive due to stress or irregular lifestyle habits.
Furthermore, the reason why colon cancer can lead to constipation is that the cancer cells growing inside the intestines obstruct the passage of stool. Therefore, if you experience persistent hard, lumpy stools, you should consult a medical professional for a proper diagnosis.

What is Irritable Bowel Syndrome (IBS)?

Reviewing your lifestyle is essential for improving hard, lumpy constipation.

Hard, pellet-like black stools, similar to rabbit droppings, occur when stool remains in the large intestine, loses moisture, and hardens. Therefore, reviewing your lifestyle is important to improve hard, pellet-like stools.

Start with what you can do, such as making sure you get enough fluids and fiber, and developing the habit of sitting on the toilet slowly in the morning. Use the solutions introduced in this article to resolve your bowel problems and enjoy a healthy life.

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