Find Relief From Ulcerative Colitis Constipation

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Ulcerative colitis (UC) is a form of inflammatory bowel disease (IBD) that causes the lining of the colon to become inflamed. Ulcers can form in the large intestine and produce pus and mucus.

Symptoms can vary among people but may include bloody stools, abdominal pain, loose or urgent bowel movements, and persistent diarrhea. Constipation (infrequent or difficult to pass bowel movements) may also occur in people living with ulcerative colitis.

Read on to learn about the link between ulcerative colitis and constipation, how to manage it, and when to see a healthcare provider.

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The Link Between Ulcerative Colitis and Constipation

Some people with UC whose active disease is on the left side of their colon will experience constipation on the right side of the colon. This is referred to as proximal constipation.

Proximal constipation may cause symptoms like:

  • Harder stools
  • Reduced number of bowel movements
  • Abdominal pain and straining to complete bowel movement
  • Gas
  • Feelings of incomplete bowel movements

Proximal constipation is considered common in people with ulcerative colitis, particularly women with the disease. Women with ulcerative colitis are 3 times more likely than men to have proximal constipation.

Treatment for Constipation

People with UC may find relief through dietary changes, increasing their fluid intake, or taking medication. However, people living with ulcerative colitis should speak with their healthcare provider first before making changes to their diet or trying any medications.

Dietary Changes

Increasing fiber can help relieve constipation. In general, a diet that contains 20–35 grams of fiber every day will help form stools that are soft and bulky.

However, people with UC should not increase their fiber intake without first talking to their healthcare provider or dietitian. If your healthcare provider approves increasing your fiber intake, do so slowly to avoid bloating or gas.

Fruits that are high in fiber include:

  • Prunes
  • Figs
  • Apples
  • Berries
  • Pears
  • Dates
  • Kiwis
  • Avocados
  • Oranges

Fruits with edible skin have a lot of fiber, so don't peel off the skin before eating.

Vegetables can also be good sources of fiber. Options to add to your diet include:

  • Corn
  • Broccoli
  • Spinach
  • Squash
  • Carrots
  • Beets
  • Potatoes with the skin on

Other ways to incorporate fiber into your diet include:

  • Eating whole-grain bread, pasta, or crackers
  • Swapping white rice for brown rice or wild rice
  • Switching to high-fiber cereals (with bran)
  • Eating legumes like kidney beans or chickpeas
  • Snacking on peanuts, almonds, or walnuts

It's also recommended that you avoid processed foods or fast food when you are constipated. This can include:

  • White bread
  • Sausages
  • Potato chips
  • French fries
  • Doughnuts
  • Pastries

Don't Skip Meals

When constipated, it's important to not skip meals. Eating initiates the waste reflex, which is the process in which your body produces and accumulates waste for elimination. If you're not eating, then your body won't create a bowel movement.

Fluid Intake

Increasing the amount of fluid you drink may help with constipation, because it helps form softer stools that are easier to pass in a bowel movement. Aim to drink eight to 10 cups of water every day.

When constipated, try adding two to four extra glasses of water a day to get your fluid intake up.

As well as increasing fluids like water, cutting down or avoiding caffeine and alcohol may help.

Exercise

Those who exercise often are less likely to develop constipation. This is because the muscles in the abdominal wall and the diaphragm (muscle at the base of the chest) have an important role in bowel movements. If the muscles in the abdomen and diaphragm are weak, regular bowel movements can be more challenging.

If you can, try to move your body at least three to four times a week.

Medication

As well as diet changes and exercise, there are a number of medications that may treat constipation. It's important that people with UC do not start or change a medication without first consulting with their healthcare provider.

Over-the-counter options to treat constipation include stool softeners and laxatives. Your provider will be able to advise you on which options are best for you. It's important to follow their instructions carefully, as overusing medications like laxatives may make constipation worse.

There are also prescription medications that may help constipation. Possible options include:

  • Linzess (linaclotide)
  • Kristalose (lactulose)
  • Trulance (pecanatide)
  • Motegrity (prucalopride)
  • Amitiza (lubiprostone)

When to See a Doctor

You should speak with your healthcare provider anytime you are concerned about symptoms.

If you experience any new, changing, or worsening symptoms, or symptoms that may indicate a flare-up, speak with your provider.

It is important that people with UC monitor their symptoms and seek medical attention when necessary.

Symptoms that may require medical attention include:

  • Feeling blocked up or having a blockage
  • Urgent feelings to have a bowel movement
  • Cramps or abdominal pain
  • Loss of appetite
  • Tiredness and fatigue
  • Weight loss
  • Frequent diarrhea that is watery or may contain blood, mucus, or pus

Summary

Constipation is when a person experiences infrequent bowel movements or movements that are difficult to pass, which can feel like blockages. It is a common symptom of ulcerative colitis. Treatments include dietary changes (like eating high-fiber foods), increased fluid intake, and exercise, which can speed up the movement of stool through the colon.

A Word From Verywell

Constipation is uncomfortable. Experiencing constipation on top of a chronic health condition like ulcerative colitis can be even more daunting. Fortunately, there are treatment options to help resolve constipation and provide relief. Talk to your healthcare provider about your constipation and be sure to consult with them before making any dietary changes.

Frequently Asked Questions

  • What are the first symptoms of ulcerative colitis?

    Symptoms of ulcerative colitis can differ for everyone but may include urgent bowel movements, loose bowel movements, blood in stools, abdominal pain or cramping, and persistent diarrhea.

  • Can constipation cause inflammation?

    Ulcerative colitis is an inflammatory bowel disease. It can cause the lining of the colon to become inflamed. This can lead to constipation. Constipation itself does not cause the inflammation, rather the UC itself does.

  • How long is too long to be constipated?

    Generally speaking, constipation refers to having three or fewer bowel movements a week. But the time to seek medical attention varies among people. If you are regularly constipated, you may try some home remedies before seeing a healthcare provider. However, if you are someone who rarely gets constipated and suddenly becomes constipated, you should speak with your provider.

  • When is constipation an emergency?

    In some cases, constipation can be a medical emergency. Warnings signs to watch for include:

    • Not having a bowel movement for an extended period of time
    • Major bloating
    • Severe abdominal pain
    • Vomiting
    • Blood in stools
    • Unexplained weight loss

    If in doubt, see a healthcare provider.

11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Crohn's and Colitis Foundation. Signs and symptoms of ulcerative colitis

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  4. Crohn's and Colitis UK. Diarrhea & constipation.

  5. Johns Hopkins. Constipation.

  6. MedlinePlus. Constipation - self-care.

  7. Cleveland Clinic. Constipation.

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  9. Crohn's and Colitis Australia. When to seek medical attention.

  10. GI Society. Inflammatory Bowel Disease

  11. Cleveland Clinic. How to know when constipation is an emergency.