Ulcerative colitis causes inflammation and ulceration in the colon, which can lead to constipation. There are several remedies for ulcerative colitis constipation, including medications and lifestyle changes.
Ulcerative colitis is a chronic disease that affects the lining of the large intestine, causing inflammation and ulceration.
Diarrhea and constipation symptoms can cause discomfort and affect a person’s quality of life. However, there are some ways in which people with ulcerative colitis can remedy constipation. These remedies include lifestyle and diet changes, laxatives, and other medications
In this article, learn more about the link between ulcerative colitis and constipation and get some tips on how to manage this symptom.
Common symptoms of ulcerative colitis include diarrhea and bloody, frequent stools, but constipation can also affect some individuals.
A person has constipation when they have
There are different types of ulcerative colitis, including distal ulcerative colitis.
In distal ulcerative colitis, the symptoms only affect the left side of the colon. When a person has ulcerative colitis on the left side, they can experience constipation on the right side — this is called proximal constipation.
Is there a link between stress and constipation? Find out here.
There are many ways to treat constipation in people with ulcerative colitis, depending on the severity of the symptoms and the person’s lifestyle.
These remedies can include lifestyle changes and prescription medications.
Dietary changes are usually the first step in managing this symptom.
These changes include:
- Consuming a high fiber diet: Current guidelines recommend that adults consume
22–34 grams (g) of dietary fiber a day, depending on their age and sex. Adding more plant-based foods to the diet and switching from white to whole grain bread are two ways to do this. - Drinking water: Drinking about 2 liters of water a day can help. Exceeding this quantity does not appear to bring additional benefits, so people should not drink more unless they are thirsty.
- Eating a nutrient-rich, plant-based diet: This diet should include plenty of fresh fruit and vegetables.
Tracking bowel movements can help a person determine whether their condition is getting better or worse.
Other useful practices include eating high fiber foods at a regular time each day, such as for breakfast, and attempting to have a bowel movement at the same time each day.
Tips to help keep bowel movements regular include:
- tracking bowel movements in a journal, noting the time, frequency, and type
- striving for regularity in bowel movements but not straining
- avoiding delaying bowel movements
Low impact exercise options include walking, swimming, and doing yoga.
If diet, hydration, and exercise do not ease symptoms, some people with ulcerative colitis may find relief from constipation by taking over-the-counter (OTC) laxatives.
People should use laxatives of any kind, including OTC medications, with caution. It is best to ask a doctor’s advice before starting to use any laxatives, as they can have some adverse effects.
A range of other medications and prescription laxatives may help a person with constipation find relief.
These include:
- Magnesium: A low dose can usually lead to a bowel movement within 6 hours.
- Lactulose: Although it can cause gas and may take longer to work than other options, lactulose can also relieve chronic constipation.
- Sorbitol: This artificial sweetener is as effective as lactulose in relieving constipation and usually costs less.
- Polyethylene glycol (PEG): Healthcare professionals mainly use PEG to clean out the digestive tract before a colonoscopy. However, one or two daily doses of 17 g can relieve chronic constipation.
- Anthraquinones: Senna and other stimulant laxatives activate the digestive system and can usually promote a bowel movement within 6–8 hours. They may cause cramps, however.
- Diphenylmethane derivatives: These are similar to anthraquinones and can help people experiencing temporary constipation. Types include bisacodyl.
- Castor oil: This oil can stimulate the intestines, but it may cause cramping.
- Stool softeners: Examples include docusate sodium and mineral oil emollients. These treatments may not be suitable for long-term use. The use of mineral oils, for example, may lead to seepage and reduce the body’s ability to absorb some nutrients.
- Enemas: Enemas work by distending and irritating the intestine. They are usually safe to use, but people should administer them with care to avoid damage.
- Suppositories: OTC glycerin suppositories are available, but there is little evidence to support their use.
In addition to finding effective treatments, it is important to have the support of people who understand the experience of living with ulcerative colitis.
IBD Healthline is a free app for people who have received a diagnosis of ulcerative colitis. The app is available on the App Store and Google Play. Download it here.
Conditions other than ulcerative colitis that may cause constipation include:
IBS
IBS can cause cramping, bloating, and changes in bowel habits, including constipation. However, it does not involve inflammation, and it does not cause severe damage to the intestines.
Experts do not know why IBS happens, but it does not appear to involve an immune system response.
IBS can cause constipation, diarrhea, or both. Ongoing abdominal pain is also a common IBS symptom.
Crohn’s disease
Ulcerative colitis only attacks the large intestine and the rectum.
Crohn’s disease is another form of IBD that can occur anywhere along the gastrointestinal tract, which runs from the mouth to the anus. However, it commonly affects the small intestine.
Constipation can signal that the disease is getting worse. It may indicate a stricture or narrowing of the intestine, also known as an obstruction.
There are several types of Crohn’s disease. Learn more here.
Celiac disease
A person with celiac disease has an inflammatory response to gluten in the diet. This response causes injury to the lining of the small intestine. The symptoms eventually disappear if a person removes products that contain gluten, such as bread and pasta, from the diet.
People with ulcerative colitis can learn to manage the symptoms of flare-ups while increasing the length of remissions. Find out how to do this.
A person with ulcerative colitis should have regular checkups with their doctor to discuss changes in their symptoms, including constipation.
Symptoms that require medical treatment include:
Without treatment, ulcerative colitis can lead to a number of complications. Find out why it is essential to see a doctor if symptoms arise.
Experts have not yet identified exactly what causes ulcerative colitis, but many believe that it is an autoimmune disease that results from a combination of genetic and environmental factors.
It is a long-term, or chronic, condition, and the symptoms can change or worsen over time.
However, treatment is available. Options
- Aminosalicylates: These help manage inflammation.
- Corticosteroids: These help reduce inflammation and regulate the immune system.
- Immunomodulators and biologic treatments: These change how the immune system works.
- Other medications: Various options can help manage symptoms.
With treatment, symptoms can go away for weeks, months, or even years. This symptom-free period is called remission. However, some people will eventually need surgery.
For people with ulcerative colitis, constipation may be a recurring problem. Following a treatment plan and dietary guidelines can help a person manage the condition and improve their overall quality of life.
Q:
Is it safe to eat high fiber foods with ulcerative colitis, or might they irritate the gut?
AnonymousA:
People with ulcerative colitis should eat a diet that is rich in fruits and vegetables except during flare-ups. At this time, they should eat a low fiber diet.
Saurabh (Seth) Sethi, M.D., MPHAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.Below are frequently asked questions relating to ulcerative colitis constipation.
Can you have constipation with ulcerative colitis?
Ulcerative colitis often causes diarrhea and bloody stools, but constipation may affect some individuals.
What helps constipation with ulcerative colitis?
Treatment options for ulcerative colitis constipation include:
- diet changes
- increasing activity levels
- over-the-counter laxatives
- prescription medications such as stool softeners and polyethylene glycol
Why do I get constipated with ulcerative colitis?
If ulcerative colitis affects only one side of the colon, it can cause constipation on the other side. It is unclear exactly why this happens, but it may be due to alterations in colon muscle movement.
Is it OK to take a laxative if you have ulcerative colitis?
Laxatives are a common treatment for ulcerative colitis constipation. However, they can lead to adverse effects, so people should use them with caution and under medical guidance.