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.

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 stoolsReduced number of bowel movementsAbdominal pain and straining to complete bowel movementGasFeelings 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:

PrunesFigsApplesBerriesPearsDatesKiwisAvocadosOranges

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:

CornBroccoliSpinachSquashCarrotsBeetsPotatoes with the skin on

Other ways to incorporate fiber into your diet include:

Eating whole-grain bread, pasta, or crackersSwapping white rice for brown rice or wild riceSwitching to high-fiber cereals (with bran)Eating legumes like kidney beans or chickpeasSnacking 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 breadSausagesPotato chipsFrench friesDoughnutsPastries

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 blockageUrgent feelings to have a bowel movementCramps or abdominal painLoss of appetiteTiredness and fatigueWeight lossFrequent 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.

Not having a bowel movement for an extended period of timeMajor bloatingSevere abdominal painVomitingBlood in stoolsUnexplained weight loss

If in doubt, see a healthcare provider.