Straining describes excessive physical effort required to initiate or complete defaecation — bearing down forcefully, spending prolonged periods on the toilet, or experiencing difficulty passing stools despite urgency. It is a primary feature of constipation and occurs when stool is hard, large, or located in a rectal position that requires significant propulsive force to evacuate. Chronic straining elevates intra-abdominal pressure with each episode, contributing to haemorrhoids (dilated venous plexuses in the anal canal), anal fissures (small tears in the anal lining), pelvic floor prolapse, and, potentially, diverticular disease through chronically elevated colonic pressures.

What lifestyle changes can help with straining?

Increase dietary fibre and fluid. Use a footstool to adopt a squatting position (reduces anorectal angle). Never strain excessively — if not passing, leave and try later.

What integrative approaches support straining?

Dietary fibre has strong evidence. Footstool positioning has strong evidence. Pelvic floor biofeedback has strong evidence for dyssynergia.

When should I seek professional support for straining?

Seek assessment for chronic straining with rectal bleeding, significant haemorrhoids, or suspected pelvic floor dysfunction. Pelvic floor physiotherapy for dyssynergia.

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Straining

Effortful, uncomfortable evacuation of the bowels requiring significant physical effort or bearing down.

Understand what may be causing this

Reviewed by Internal Medical Editorial Team · Integrative Health Content Review26 March 2026Strong Evidence

Quick answer

Effortful, uncomfortable evacuation of the bowels requiring significant physical effort or bearing down.

Recognition

Do any of these feel familiar?

Spending 10–20 minutes on the toilet, bearing down hard, feeling incomplete evacuation despite significant effort, and sometimes achieving nothing despite the urge.

What is Straining?

Effortful, uncomfortable evacuation of the bowels requiring significant physical effort or bearing down.