Q. I often have to push hard and strain hard to get a small amount of stool out. Why?

Answered by
Dr. Ajeet Kumar Lohana
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 28, 2021

Hi doctor,

I am having trouble going to the bathroom. The stool is usually small, and I feel I am unable to push everything out. Often have to push hard and strain hard to get a small amount of stool out. I am constantly bloated, and it can be quite uncomfortable at times. This has been going on for three years. I eat a good amount of fruit and vegetables to try to get as much fiber as possible. When I go on a jog or run, it usually helps me to go to the bathroom. I had surgery to get my appendix taken out around three years ago, unsure if that could have something to do with my symptoms. How would I be able to fix this?



Welcome to

I can understand you must be very concerned about this ongoing problem. Well, the appendix operation may have started all this. The abdominal cavity is opened via any surgery. It always probes the bowel (small and large bowel) to respond differently in some because hyperactive causes diarrhea, and in some, like in your case, it becomes slower and causes constipation. The straining, failure to completely evacuate bowels seems the problem of the lowest most part of the large bowel, like the anal canal, rectum. Since you already have enough fiber and water intake, I do not think you have any diet-wise problems that you can correct. It would be best if you had some testing to confirm it before any further treatment. Although you always try Isabgol husk, two tables spoon full daily with water on an empty stomach, and two liters of water routinely. Also, start using Movicol Sachet (Polyethylene glycol) 17 grams sachet. Take two sachets every night with water and see if they help your bowel movement. You can increase the dose to two sachets twice or thrice daily for maximal benefit. It would help if you got barium defecography as an investigation to confirm the problem of ejecting stools from the rectum. In this, a radiologist gives a barium enema and asks you to push it out, while at the same time, they will take x-ray images of the passage of the enema. Try with the medicines first, and if still there is no relief, go for the test as suggested.

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