Constipation is one possible complication of ulcerative colitis (UC). Simple strategies like drinking more water and exercising may help you get relief.

Ulcerative colitis (UC) is an inflammatory bowel disease that causes inflammation along the lining of your large intestine and rectum.

UC causes symptoms such as diarrhea, stomach pain, and needing to pass stools frequently. For some people, it can also cause constipation.

Constipation means that it’s difficult to pass stools or you pass stools less often than usual. While bowel habits can differ from person to person, you may have constipation if you:

  • pass fewer than three stools per week
  • strain during bowel movements
  • have hard, pellet-like stools
  • feel like you still need to go when you’ve already passed stool

Constipation is problematic if you have UC. An inability to pass stools can trigger gas and nausea, complicating the condition. You may also experience pain if hard stools pass through inflamed areas of your intestines.

Corticosteroids and immunosuppressant drugs are often prescribed to treat UC. But even if you take these medications for your condition, you may need other remedies to help manage constipation.

Hydration contributes to healthy gastrointestinal function. According to the National Institute of Diabetes and Digestive and Kidney Diseases, drinking plenty of water each day can help soften stools and make them easier to pass. When you aren’t getting enough fluids, dehydration can make constipation more likely.

Try keeping water beside you during the day and taking sips every 20 minutes. Consider limiting your intake of caffeinated beverages like coffee and cola. Caffeine is a diuretic, which can cause dehydration.

Your doctor may recommend osmotic laxatives to help ease constipation from UC. One type is polyethylene glycol 3350 (MiraLAX).

This type of laxative induces bowel activity by increasing the amount of water in your intestines, which softens stools. This is a slow-acting laxative, so expect a bowel movement within 2 to 3 days.

Osmotic laxatives are usually recommended over other types for people with inflammatory bowel conditions like UC. But it’s important to talk with your doctor before using any type of laxative if you have UC.

Increasing your intake of dietary fiber can help soften stools and make them easier to pass. However, be aware that too much fiber may worsen symptoms of colitis in some people. People with UC should talk with a doctor before changing their diet.

It may help to keep a food journal to identify potential problem foods. For example, your body may tolerate certain types of fruit, but not others. Or you may experience worsening symptoms after eating broccoli or cabbage, but other types of vegetables aren’t a problem.

For most adults, the recommended amount of fiber is 22 to 34 grams per day. Increase your fiber intake slowly and allow your body to adjust. Fiber-rich foods include:

  • vegetables
  • fruits
  • whole grains

If raw fruits and vegetables irritate your colitis, steam or bake these foods and monitor your symptoms.

Stool-bulking agents, also called bulk-forming laxatives, increase the volume of your stools. One type is psyllium fiber (Metamucil).

Bulking up stools can make them easier to pass. Take these laxatives as directed on the label, and be sure to keep yourself well-hydrated to help them work properly.

Taking extra fiber during an active UC flare can make the condition worse. Talk with your doctor before starting a stool-bulking agent such as psyllium.

You should stop taking this type of laxative if you experience side effects, such as:

  • stomach pain
  • vomiting
  • nausea

Decreased physical activity may also play a role in UC constipation. A sedentary lifestyle slows digestion and intestinal contractions. This makes it harder for stools to pass through your intestinal tract.

Getting regular exercise may normalize bowel function. And a 2015 study that looked at the relationship between constipation and lifestyle factors found that people who regularly exercise had a lower risk of constipation.

Increase your level of physical activity to see whether constipation improves. Start with low to moderate intensity workouts, and then gradually increase intensity as your endurance improves.

Go for a walk or swim, ride your bike, or participate in enjoyable sports. The American Heart Association recommends 150 minutes of moderate intensity exercise per week. But low intensity exercise is better than none at all.

Ask your doctor about biofeedback if you find that other lifestyle changes and treatments are not helping with constipation. This type of physical therapy may improve bowel function.

It retrains pelvic floor muscles through relaxation techniques, which in turn can stimulate bowel activity. In one small study that included 21 people with chronic constipation, all of them reported having significantly more weekly bowel movements with adaptive biofeedback therapy.

However, experts suggest that there isn’t enough evidence to know whether biofeedback is safe and effective in general.

If you decide to try biofeedback therapy, follow your doctor’s and physiotherapist’s recommendations for the best results.

Constipation with UC can trigger gas and stomach pain, which can worsen your condition. Don’t ignore prolonged constipation.

If UC constipation doesn’t improve with treatment or lifestyle changes, talk with your doctor.