Chronic kidney disease (CKD) can lead to a variety of digestive symptoms such as loss of appetite, nausea, and diarrhea. For many people, CKD can also lead to constipation.
There are a few different reasons why constipation can occur with chronic kidney disease (CKD). Common reasons include:
- a lack of fiber in diets intended for people with CKD
- fluid restrictions for people with later stage CKD
- co-occurring or secondary conditions
- medication side effects
Treatments, which include lifestyle changes such as eating more fiber and increasing exercise levels, can often help relieve symptoms.
This article takes a closer look at the causes and treatment of constipation in people with CKD. We also review the early symptoms of kidney disease and kidney failure. Constipation isn’t typically a symptom of kidney failure.
- Renal diets: It can be difficult enough for people eating a standard American diet to get the fiber they need. People who are on a renal diet are limited in their food choices, and many foods that are high in fiber have traditionally been excluded. But
newer recommendationsfor people with chronic kidney disease are less strict about fiber-rich foods such as fruits and vegetables, meaning it’s safe to add these foods to your renal diet.
- Co-occurring conditions: Many of the conditions that commonly occur alongside kidney disease, such as diabetes, hypothyroidism, and hypercalcemia, can slow down your digestive system. A slow digestive system can lead to constipation.
- Bacterial imbalance in the stomach: A bacterial imbalance in the stomach, called dysbiosis, can occur when your kidney isn’t working correctly. It happens because your kidneys aren’t filtering bacteria. This leads to an abnormal mix of bacteria in your stomach, which can cause constipation.
- Medication reactions: People with kidney disease may develop secondary conditions such as gout, anemia, or bone disease. Some of the medications prescribed for these secondary conditions, including blood pressure medications, iron supplements, anti-nausea medications, and calcium supplements, can cause constipation in some people.
- Fluid restrictions: People with later stage kidney disease may need to restrict their fluid intake — especially those undergoing dialysis. This can make it difficult to get enough hydration to avoid constipation.
Treating constipation depends on several factors, but often, lifestyle and diet changes can help resolve the condition. Doctors typically recommend starting with lifestyle changes before progressing to medication.
Lifestyle treatments that can help people with chronic kidney disease get relief from constipation include:
- Eating more fiber: Getting enough fiber in your diet is one of the best ways to combat constipation. Fiber helps carry waste through your system. It’s found in a variety of foods, including whole grains, nuts, lentils, beans, oats, apples, pears, and vegetables.
- Increasing your activity: Fitness combats constipation. Exercise helps your blood flow and helps food move through your digestive system. You can start small; even walking a little every day will make a difference.
- Increasing fluids: Fluids are one of the best ways to beat constipation. People with chronic kidney disease can talk with their doctors about the best way to get enough fluid to keep their digestive systems moving.
- Try probiotics: Probiotics are live microorganisms that are found in fermented food that can help relieve constipation. Fermented foods included options such as yogurt, sauerkraut, miso, kimchi, tempeh, natto, and homemade pickles. Ask your doctor or dietician about the right amount of these foods to add to your diet.
- Relieve symptoms with an over-the-counter (OTC) medication: If your symptoms are severe and haven’t been relieved by methods such as hydration or fiber, an OTC medication can help. However, it’s important not to take these medications for longer thana few days. OTC options include stool softeners, stimulant laxatives, and fiber supplements.
- Prescription-strength medications: Your doctor might prescribe prescription versions of any medication if lifestyle changes aren’t enough.
- Biofeedback therapy: Biofeedback therapy is a treatment that retrains the muscles that control bowel movements.
- Surgery: Sometimes, surgery to remove a blockage in part of your colon might be an option.
How does constipation affect the outlook for people with chronic kidney disease?
Constipation can affect the quality of life and outlook for people with CKD. A
Constipation isn’t typically an early sign of kidney disease. It’s more common for kidney disease to cause early symptoms such as:
As kidney disease progresses, it can cause increased symptoms. Some symptoms are similar to early symptoms but more severe. Other symptoms are unlikely to show up until chronic kidney disease has progressed to kidney failure.
Symptoms of kidney failure include:
- skin rash
- itchy skin
- very pale skin
- unexplained muscle cramping
- bone pain
- no urine production or excessive urine production
- unusual bleeding
- nose bleeding
- back pain
- stomach pain
- a mass in the stomach
- diarrhea that is sometimes bloody
- loss of appetite
- bad breath
- a metallic taste in the mouth
- vomiting that is sometimes severe
- swelling throughout the body
- difficulty hearing
Chronic kidney disease doesn’t always cause constipation, but there are a number of reasons why it does for many people with CKD. Renal diets, fluid restrictions, medications, co-occurring disorders, and more can all lead to constipation.
Treatment can bring relief and often includes lifestyle changes such as eating more fiber, getting more exercise, and increasing fluids. When these methods aren’t enough, medications, biofeedback, and surgery can be options.