Written by: Betty Staff
TABLE OF CONTENTS
----------------------------------------------------
How to keep your bowel routine comfortable and healthy.
1. Stay Hydrated
When you drink enough fluids, your body can pull less water out of your stool as it passes through the colon – which keeps your poop softer and easier to pass. Dehydration can lead to hard, dry stools that can cause straining, small tears, inflamed hemorrhoids, and anal fissures. Aim for at least 6–8 cups of water a day – more if you’re active or breastfeeding.
2. Eat a High Fiber Diet
Fiber adds bulk and softness to stool and feeds good gut bacteria. Load up on veggies, fruits, whole grains, and legumes. If needed, try a fiber supplement like psyllium, but be sure to pair it with plenty of water to avoid constipation.3. Poop in Proper Position
Straining increases pressure on the anal area. Use a footstool or toilet stool to raise your knees and straighten the anorectal canal for easier elimination. Avoid sitting too long (no scrolling!) to prevent added strain.4. Move Your Body.
Physical activity, especially walking, helps stimulate peristalsis, the wave-like contractions that move stool through your colon. It also prevents sluggish digestion and stool hardening.5. Sleep and Manage Stress
Your gut and brain are closely connected. Poor sleep and chronic stress can disrupt digestion and slow motility. Daily breathwork, yoga, or meditation can support regularity and healing.6. Be Gentle with Shower Hygiene
In the shower, skip harsh soaps as they can irritate the sensitive anal and vulvar skin and throw off your pH balance (the measure of how acidic or alkaline something is). If you want more than water to wash, seek a gentle cleanser that is fragrance free, pH balanced, specifically designed for intimate skin and dermatologist tested.
7. Be Careful When You Wipe
Rubbing dry toilet paper over delicate skin can cause tiny tears and worsen irritation. Using a bidet, portable bidet or moistening toilet paper with a TP spray, gel or foam makes cleanup easier and gentler. This is especially helpful if your stools are soft and sticky.
If you do select to use a TP spray, gel or foam, opt for one that is fragrance free, pH balanced and dermatologist tested.
Steer clear of baby wipes because they often contain chemicals that can cause contact dermatitis and make the skin more reactive over time. Plus, the flushability of most “flushable” wipes is suspect and can cause plumbing issues as well as environmental concerns.
Should I use laxatives or stool softeners to avoid hemorrhoids if constipated?
If you are feeling constipated and basic modifications to your hydration, diet and movement aren’t helping, you might want to consider laxatives. But not all laxatives are created equal! Here are some helpful tips about picking what option is right for you.
Non-Stimulant Laxatives
Betty’s Clinical Advisor, and double board-certified colorectal surgeon Dr. Ritha Belizaire, typically encourages patients to try a non-stimulant laxative first with LOTS of water/hydration.
How do non-stimulant laxatives work?
Non-stimulant laxatives help soften stool or increase its bulk so it moves more naturally through your colon. They don’t directly “force” your bowels to contract.
What are the types of non-stimulant laxatives?
- Bulk-forming laxatives (like psyllium, methylcellulose) — add fiber to absorb water and make stool softer and easier to pass.
- Osmotic laxatives (like polyethylene glycol/PEG, lactulose) — draw water into the intestines to soften stool and stimulate gentle movement.
- Magnesium-based laxatives (like magnesium citrate or Milk of Magnesia): A certain type of osmotic laxative, while effective for occasional constipation, they should be used with caution in people with kidney problems and not taken frequently, as too much magnesium can build up in the body.
Stimulant Laxatives
If it’s been a few days and you still can’t get things moving, you might want to discuss a round of short course stimulant laxatives with your doctor.
How do stimulant laxatives work?
Stimulant laxatives trigger the muscles of the intestines to contract more forcefully, thereby pushing stool out more quickly.
What are the types of stimulant laxatives?
The major types of stimulant laxatives are:
- Senna (Senokot)
- Bisacodyl (Dulcolax)
- Castor oil (less commonly used now).
Why do doctors not recommend stimulant laxatives first?
Stimulant laxatives typically should not be used for more than 48 hours, may cause cramping, and if overused may cause dependency.
Stool Softeners
Recent research suggests stool softeners (aka docusate sodium) don’t work any better than placebo on easing constipation!
The Bottom Line About Constipation
If you ever see blood in the toilet or notice pain that doesn’t improve, check in with your doctor. Many anorectal conditions are mild and manageable at home, but it’s always best to rule out anything more serious.