Causes of Hard, Small, and Pellet-Like Stool

If you have small, hard stools that are shaped like pebbles or pellets, you may wonder if this is normal or something you should worry about. Most often, this is a sign that your diet is low in fiber. But there may other reasons for this type of constipation, some of which may be more concerning than others.

This article details five factors that can lead to pellet-like stools and when it's time to see a doctor.

Too Little Fiber

The size of your stool is influenced by the amount of fiber you consume. Plant-based fiber from vegetables, fruits, and whole grains adds bulk to your stool. It also promotes fermentation and creates a gel that keeps poop from breaking into pieces.

If you have enough fiber in your diet, your stool should be soft, well-formed, and easy to pass. If you don't, your stool is more likely to be hard, dark, pebble-like, and difficult to pass.

On average, adults consume less than 15 grams of fiber per day—far less than the recommended 38 grams for males and 25 grams for females under the age of 50.

If you're not sure how much fiber you're eating, try keeping a food diary. If you use a diet-related smartphone app, it may already be tracking your fiber intake for you.

By keeping track of how much fiber you consume, you can see if you are getting enough and increase your intake if needed.

Here are some fiber-rich foods to add to your diet:

Increase your intake gradually to avoid bloating and gas. Fiber supplements can also help if you still having trouble with constipation.

Not Enough Fluids

Soluble fiber is the type that dissolves in water and includes plant-based pectin and gums that hold stools together

Fiber and water work together to make stools that are easy to pass. If you aren't drinking enough water, there won't be enough in the gut for soluble fiber to absorb.

When it comes to getting enough water, many experts will tell you to use thirst as a guide and to look for varied sources such as fruits, vegetables, herbal teas, juices, soups, and non-caffeinated beverages.

According to the Institute of Medicine (IOM), you should consume no less than 15.5 cups of fluids per day from all sources if you are an adult male and 11.5 cups if you are an adult female. Factors like age, body weight, activity level, and certain health conditions may require you to increase or decrease your intake.

If you aren't sure how much water is right for you, speak with your doctor.

Medications

Your constipation may have nothing to do with fiber or water. In some cases, the drugs or supplements you take can alter the way that your body digests food.

These include medications such as :

• Antacids
• Antidepressants
• Calcium channel blockers
• Diuretics
• Iron supplements
• Opioid drugs
• Parkinson's disease medications

If you are on any of these and are constipated, let your doctor know. In some cases, the drug dose may be adjusted or the treatment changed. Stool softeners may also help ease the passing of stools.

Lifestyle Issues

Spending hours at your desk hunched over a keyboard or leading a sedentary lifestyle can slow digestion. By contrast, moving around helps stimulate the gut and speeds the passage of stools before too much water is absorbed.

If you are stuck at a desk, get up and move every hour or so to improve your digestion. It also helps to exercise regularly. Even 30 minutes of low-impact activity every day, such as a brisk walk, will help.

Make time to go to the bathroom if you feel the urge to go. Ignoring the urge can make constipation worse.

You can also try getting up earlier to eat breakfast, which can promote bowel movements before your day really gets started.

Health Conditions

Constipation can sometimes be a sign of an underlying health condition. Some of these can slow the movement of stools through the gut, while others reduce the level of digestive enzymes the body produces.

Conditions linked to constipation include:

• Diabetes
• Diverticular disease
• Hypothyroidism (underactive thyroid gland)
• Inflammatory bowel disease (IBD)
• Irritable bowel syndrome (IBS)
• Multiple sclerosis (MS)
• Parkinson's disease
• Uterine fibroids
• Colon cancer

In cases like these, constipation is usually treated with diet, exercise, laxatives, and/or stool softeners. The treatment of the underlying condition is also crucial.

When to See a Doctor

Having small stools from time to time is usually nothing to worry about. However, speak with a doctor if they last for longer than two weeks and you don't know why.

If hard, pebble-like stools are accompanied by symptoms such as cramping, fever, nausea, vomiting, or rectal bleeding, see a doctor immediately. These could be signs of a more serious health issue.

Summary

Constipation with small, hard, pebble-like stools is generally a sign of a low-fiber diet. Other contributing factors including drinking too little water or having an inactive lifestyle.

Certain medications and medical conditions can also cause constipation, even if you are active and consume plenty of fiber.

If constipation lasts more than two weeks and has no known cause, speak with a doctor.

A Word From Verywell

The first thing some people do when they have constipation is reach for a laxative. This can be a problem for two reasons.

Firstly, the practice can lead to laxative dependence in which you're only be able to go when you take the medication. Secondly, laxatives can mask the underlying cause of constipation, meaning it may go undetected until the condition becomes more serious.

In the end, there is no such thing as "normal" chronic constipation. If you are struggling on a regular basis, see a doctor. Even if you are otherwise healthy, there are strategies beyond laxatives that can help.