Ulcerative colitis and constipation

Constipation is one possible complication of ulcerative colitis (UC). UC is an inflammatory bowel disease that causes inflammation along the lining of your large intestine and rectum. There’s a greater risk of UC constipation when inflammation occurs in your rectum.

This type of UC is known as proctitis. Because of spasms, the pelvic floor doesn’t relax. This interferes with normal bowel activity, making it difficult to pass stools.

Constipation refers to less than three stools a week, straining during bowel movements, or having hard, pellet-like stools. This is problematic if you have UC: An inability to pass stools can trigger gas and stomach pain, complicating the condition.

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 a study from 2011, increasing your fluid intake may relieve constipation because dehydration hardens stools.

Aim to drink 8 ounces of fluid per day. Drink water or decaffeinated tea. Limit your intake of caffeinated beverages. Caffeine is a diuretic, which can cause dehydration.

Stool-bulking agents, also called bulk-forming laxatives, increase the volume of your stools. This can make them easier to pass. Take these laxatives as directed with 8 ounces of fluids, preferably water or juice.

Talk to your doctor before combining a stool-bulking agent with prescription medication.

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

  • stomach pain
  • vomiting
  • nausea

Doctors often recommend osmotic laxatives as the next line of defense if constipation doesn’t improve with stool-bulking agents. 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 two to three days.

This laxative may be safer than other types of laxatives because there’s a lower risk of developing side effects, such as:

  • abdominal gas
  • cramping
  • bloating

Increase your dietary fiber intake to relieve symptoms of mild to moderate constipation. However, be aware that too much fiber may worsen symptoms of colitis in some people.

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.

The recommended amount of fiber is 20 to 35 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.

Talk to your doctor about a fiber supplement if constipation doesn’t improve.

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.

According to the Mayo Clinic, 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 if 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 exercise per week, which is roughly equal to 30 minutes for five days or 40 minutes for four days.

Ask your doctor about biofeedback if you aren’t able to resolve UC constipation on your own. This type of behavioral therapy may improve bowel function.

It retrains pelvic floor muscles through relaxation techniques, which in turn can stimulate bowel activity. In one study of 63 people with chronic constipation, all participants reported having significantly more weekly bowel movements with adaptive biofeedback therapy.

Use biofeedback in conjunction with other types of therapies and remedies for UC, such as:

  • a prescription medication
  • increased fluid intake
  • physical activity

Follow your behavioral therapist’s recommendations for the best results.

Constipation with UC can trigger painful gas and stomach pain, which can worsen your condition. Don’t ignore prolonged constipation. If it’s left untreated, UC constipation may cause a serious complication called toxic megacolon. If these remedies don’t help you manage UC constipation, talk to your doctor.