zaro

What Happens If You Strain Too Hard?

Published in Bowel Health Complications 5 mins read

Straining too hard, especially during bowel movements, can lead to a range of uncomfortable and potentially painful health conditions. While often associated with constipation, excessive straining puts significant pressure on various parts of the body, particularly the lower digestive tract, leading to distinct complications.

Immediate and Long-Term Impacts of Excessive Straining

When you exert too much force to pass stool, the increased pressure within the abdomen and rectum can cause several issues. The most common and immediate concerns are:

Hemorrhoids

These are swollen veins located in and around the anus and lower rectum, similar to varicose veins. Straining significantly increases pressure in these veins, causing them to bulge and become irritated.

  • Symptoms of Hemorrhoids:
    • Pain or discomfort, especially during bowel movements.
    • Itching or irritation in the anal region.
    • Bleeding during bowel movements, which is usually bright red and noticed on toilet paper or in the toilet bowl.
    • Swelling or a lump around the anus.

Anal Fissures

An anal fissure is a small tear or crack in the thin, moist tissue (mucosa) lining the anus. Hard, large stools, often passed with excessive straining, are a primary cause of these painful tears.

  • Symptoms of Anal Fissures:
    • Severe, sharp pain during bowel movements that can last for hours afterward.
    • Bright red blood on toilet paper or in the stool.
    • A visible crack in the skin around the anus.
    • A small lump or skin tag near the fissure.
Condition Key Symptoms
Hemorrhoids Pain, itching, bleeding, swelling in the anal area
Anal Fissures Sharp pain during/after bowel movements, bleeding, visible tear

Other Complications

Beyond hemorrhoids and anal fissures, chronic or severe straining can contribute to other issues:

  • Rectal Prolapse: In some cases, prolonged straining can weaken the muscles and ligaments that hold the rectum in place, causing a portion of it to protrude outside the anus.
  • Pelvic Floor Dysfunction: Consistent straining can weaken or damage the pelvic floor muscles, which support the bladder and bowel, potentially leading to issues with continence.
  • Increased Risk in Certain Health Conditions: For individuals with cardiovascular conditions, extreme straining can temporarily increase blood pressure and heart rate, which may pose a risk.

Why Does Straining Occur?

Straining typically occurs when stools are hard, dry, and difficult to pass. This is most often a result of:

  • Constipation: Infrequent bowel movements or difficulty passing stool.
  • Low Fiber Intake: A diet lacking sufficient dietary fiber, which helps add bulk and soften stool.
  • Dehydration: Not drinking enough fluids can lead to harder stools.
  • Lack of Physical Activity: Inactivity can slow down digestive processes.
  • Ignoring the Urge: Delaying bowel movements can make stools harder to pass.
  • Certain Medications: Some medications can cause constipation as a side effect.

Preventing the Need to Strain

Fortunately, many simple strategies can help prevent the need to strain and reduce the risk of associated complications. These focus on promoting regular, soft, and easy-to-pass bowel movements:

  • Stay Hydrated: Drink plenty of water throughout the day. Water helps soften stool, making it easier to pass. Aim for at least 8 glasses daily, or more if you are active. Learn more about hydration.
  • Eat a High-Fiber Diet: Incorporate plenty of fruits, vegetables, whole grains, and legumes into your daily meals. Fiber adds bulk to stool, helping it move smoothly through the digestive system. Gradually increase fiber intake to avoid gas and bloating. Explore high-fiber foods.
  • Stay Active: Regular physical activity helps stimulate bowel contractions, aiding in the movement of stool. Even a daily walk can make a difference. Benefits of physical activity.
  • Establish a Routine: Try to have a bowel movement at the same time each day, ideally after a meal when the gastrocolic reflex is most active.
  • Listen to Your Body: Don't ignore the urge to have a bowel movement. Delaying can lead to harder stools.
  • Proper Posture: Using a footstool to elevate your knees while sitting on the toilet can change the angle of the rectum, making it easier to pass stool without straining.
  • Consider Over-the-Counter (OTC) Aids:
    • Fiber Supplements: If dietary fiber isn't enough, supplements like psyllium (Metamucil) or methylcellulose (Citrucel) can help.
    • Stool Softeners: Docusate sodium (Colace) works by adding moisture to the stool.
    • Mild Laxatives: Used occasionally, certain laxatives can help, but they should not be relied upon long-term without medical advice.
  • Prescription Medications: In some cases, a doctor might prescribe medications for chronic constipation or to treat specific complications like hemorrhoids or anal fissures.

When to Seek Medical Attention

While many cases of straining-related issues can be managed at home, it's important to consult a doctor if you experience:

  • Persistent bleeding from the rectum.
  • Severe pain during or after bowel movements.
  • A change in bowel habits that lasts for several weeks.
  • Unexplained weight loss.
  • Symptoms that do not improve with home remedies.