It is rarely just one reason. Usually, it is a combination of **Diet, Lifestyle, and Gut Motility** (movement speed).
Fiber adds bulk to stool. Lack of fruits, vegetables, and whole grains leads to hard, dry stools.
The colon absorbs water from food. If you don't drink enough, the colon pulls extra water, making stool hard.
Physical activity stimulates intestinal muscles. Lack of movement slows down bowel transit.
Suppressing the urge to go (due to work or busy schedule) weakens the rectal sensation over time.
Painkillers (Opioids), Iron supplements, and Antidepressants are common culprits.
Pelvic floor dysfunction (Anismus) where muscles tighten instead of relaxing during defecation.
Know the difference
"You can eat all the fiber in the world, but if your pelvic muscles don't relax (Outlet Obstruction), you will still strain."
Dr. Jaya explains why drinking water helps some patients but fails for others. It depends on whether your gut is slow or your exit is blocked.
