What is a stubborn stool or constipation?

A stubborn stool is a poo that has moved too slowly through the bowel, losing water to the rest of your body so that it becomes dehydrated and hard to pass. 

You might already know that a healthy brain contains 75% water¹ – but did you know you need exactly the same amount of water content in a healthy stool?² In fact, everything your body does requires water – speaking, moving, breathing – so it’s no wonder that from time to time your stool can end up lacking the hydration it needs to leave your body easily. 

Movicol^® contains macrogol which helps to relieve the feeling of blocked bowels or constipation symptoms by binding to water and drawing it towards dehydrated stools. This hydrates and softens stools to help you ‘go’. However, many people have constipation symptoms without actually realising they have constipation, so might be unaware that Movicol^® could help relieve them of their stubborn stool. 

If you find yourself asking “What does a stubborn stool or constipation feel like?”, there are a number of common symptoms that might suggest you’re struggling to move a dehydrated stool.

The first relates to frequency: are you going to the toilet to poo fewer than three times a week? Even though we are all different and everyone has a different ‘normal’, guidance says that anything less frequent than this indicates that you are most likely experiencing constipation.³

How does it feel when you pass stools? Do you have difficult bowel movements that are making you fearful of using the toilet? This might be an indication that your stools have become hard and increasingly stubborn, making them difficult and uncomfortable to pass. Likewise, you may experience the sensation of feeling your bowels not emptying completely. 

You might notice some discomfort in other parts of your body as well; it’s possible that you may feel bloated or experience lower abdominal pain before a bowel movement, caused by a build-up of gas as a result of the blockage created by your stubborn stool. 

Stubborn stools, when left untreated, can lead to more severe and uncomfortable constipation symptoms that indicate an even more urgent need to address the underlying issue. 

In some instances, rectal bleeding can become apparent as a result of the straining that accompanies a stubborn stool⁴. A hard, dry stool can cause tears in the delicate tissue around your rectum, and you may notice this in the form of blood on the toilet paper when you wipe.

Leaving a stubborn stool or your constipation symptoms untreated even longer could lead to piles (also known as haemorrhoids), which is when the veins around your rectum or anus become swollen and turn into painful lumps on the surface.⁵

Of even greater concern is that prolonged constipation and the repeated strain of trying to go to the toilet can cause the muscles controlling your bowel movements to weaken, which could potentially result in faecal incontinence.⁶ This means you may start to lose the ability to manage your bowel movements, which might even lead to unintentional poo leakage. 

If you have any concerns we recommend you contact a healthcare professional.

The moral of the story is: never ignore the early signs of a stubborn stool or constipation symptoms.

SUMMARY 

Whether your early signs of a stubborn stool are less frequent bowel movements, pain when you go to the toilet or a sensation that you can’t quite ‘finish’, ignoring the symptoms risks developing more serious constipation, rectal bleeding, piles or even faecal incontinence.

The basic reasons and triggers for experiencing difficult bowel movements are relatively well-known, but this doesn’t make having a stubborn stool or constipation symptoms any less distressing when they happen. Despite your best efforts, a stubborn stool can strike when you least expect it and without fair warning. We know that this can lead to feelings of frustration, anxiety and occasionally even shame. But it’s important to remember that you are not alone and that help is at hand. 

There are several things that could be the root cause of a stubborn stool, a good few of which can be addressed by lifestyle or dietary changes.

A lack of exercise is one possible cause of a stubborn stool or constipation symptoms. Getting moving regularly also helps keep the muscles in your intestines active, which keeps poo moving swiftly through your digestive system. When you’re inactive, your intestinal muscles are less active too – meaning that you may experience slower bowel movements which lead to your stool staying in your body longer, losing moisture and becoming more difficult to pass. 

A lack of hydration can have the same effect. If your body is not getting enough water, it can absorb water from the poo in your bowels – again making them harder, drier and more difficult to move out of the body. As we have previously mentioned, this is how Movicol^® can help; the macrogol in Movicol^® binds with water, drawing it into your bowel and making your stool softer and easier to pass.⁷

A lack of fibre can also be a factor in constipation. Fibre bulks out your poo, helping it to retain the water that makes it softer and easier to move along your digestive system. A diet lacking in fibre leads to smaller, harder poos that are difficult to pass – and in this case you should try eating more fruits, vegetables, wholegrains and legumes to reduce constipation symptoms. 

While those factors can be tackled with adjustments to activity levels, or paying closer attention to what you eat or drink, other causes may be trickier to address. 

Stress and anxiety is known to have a considerable impact on the digestive system. For example, times of stress or anxiety can cause your body to alter the function of digestive organs such as the intestines, potentially leading to constipation symptoms.⁸

Some medications can have side effects of a stubborn stool or constipation symptoms  – opioid-based pain medication in particular, but also some antidepressants, antacids, antispasmodics, diuretics and iron supplements. Such medications may slow the movement of waste through the intestine, thereby leading to constipation – which can be particularly difficult to deal with if you’re taking medication for a chronic condition. In these circumstances we recommend you contact a healthcare professional.⁹

IN SUMMARY

Stubborn stools or constipation can be caused by: a lack of fibre, hydration or exercise; an increase in stress or anxiety; side effects of some medications (especially opioids). 

Yes, there are certain stages of life where you might find yourself more likely to experience a stubborn stool.

Pregnant people commonly experience constipation symptoms due to hormonal and physical changes in their body¹⁰.  An increase in progesterone levels can lead to muscles in the digestive system relaxing, and food moving more slowly through the intestines as a result – during which time stools can become dehydrated and harder to pass. Meanwhile, the expansion of the uterus can put more pressure on the bowels, further slowing down bowel movements.

Elderly people may find themselves more frequently constipated due to changes brought about by the ageing process. A decline in muscle tone and mobility can contribute to a greater difficulty in passing stools, while a decreased sense of thirst can result in dehydration that leads to hard, dry poo. Elderly people may be more likely to be using medications with side effects of constipation symptoms.

If you are experiencing any of the symptoms described above, there is a chance you may have a stubborn stool or be constipated. Struggling with a stubborn stool or constipation is very common and can affect people of all ages. If you think you are, firstly these symptoms are not uncommon, in fact, according to our research 77%¹¹ of people experience constipation symptoms at least a couple of times a year. The good news? Movicol® provides gentle but effective constipation relief by harnessing the power of water to hydrate and soften the stool so it passes more easily. 

Instead of waiting until the discomfort of a stubborn stool becomes too much, you can take a Movicol® sachet containing macrogol when you recognise signs of constipation symptoms arise to help restore natural bowel movements. 

If you have been taking Movicol^®  for longer than two weeks we recommend you see a healthcare professional.

IN SUMMARY

The elderly and those who are pregnant might be more prone to stubborn stools than others. Fortunately, the gentle and effective constipation relief of Movicol® is formulated to be suitable for them. Medicines can affect the unborn baby. Always talk to your doctor or pharmacist before taking any medicine in pregnancy.

Tell your doctor or pharmacist if you are taking other medicines whilst taking Movicol^®. Some medicines may not work as effectively during use with Movicol. You should not take any other medicines by mouth together with Movicol^® or for one hour before or after taking Movicol^®.

^[1] Zhang J, et. al. The Effects of Hydration Status on Cognitive Performances among Young Adults in Hebei, China: A Randomized Controlled Trial (RCT). Int J Environ Res Public Health. 2018 Jul 12;15(7):1477.

^[2] Rose C, A, Jefferson B, et al. The characterization of Feces and urine: A review of the literature to inform Advanced Treatment Technology. Crit Rev Environ Sci Technol. 2015 Sep 2;45(1Parker 7):1827-1879. 

^[3] Miller LE, Ibarra A, Ouwehand AC et. al. Normative values for stool frequency and form using Rome III diagnostic criteria for functional constipation in adults: systematic review with meta-analysis. Ann Gastroenterol. 2017;30(2) :161-167.

^[4] Bleeding from the bottom (rectal bleeding). NHS. Page last updated 12 April 2023. Accessed here: https://www.nhs.uk/conditions/bleeding-from-the-bottom-rectal-bleeding/ 

^[5] Piles (haemorrhoids). NHS. Page last updated 28 March 2022. Accessed here: https://www.nhs.uk/conditions/piles-haemorrhoids/ 

^[6] Bowel incontinence. NHS. Page last updated 04 March 2021. Accessed here: https://www.nhs.uk/conditions/bowel-incontinence/ 

^[7] Schiller LR, Emmett M, Santa Ana CA, Fordtran JS. Osmotic effects of polyethylene glycol. Gastroenterology, 1988; 94: 933-941.

^[8] Constipation. NHS. Page last updated 26 October 2023. Accessed here: https://www.nhs.uk/conditions/constipation/ 

^[9] Common causes of constipation. Harvard Health Publishing. Page last updated 18 July 2023. Accessed here: https://www.health.harvard.edu/diseases-and-conditions/common-causes-of-constipation 

^[10] Pregnancy Constipation. Cleveland Clinic. Page last updated 19 October 2021. Accessed here: https://my.clevelandclinic.org/health/diseases/21895-pregnancy-constipation 

^[11] Data on file MOVICOL 017 (DOF-MOVIC-017). MOVICOL® Omnibus and Usage and Attitude (U&A) Market Research 2023 (MR 244)