Symptom Management

Constipation is the inability to pass stools regularly or empty the bowels completely. Often the stools are dry, hard, or lumpy. Passing hard stool through an area of inflammation in your colon can be very painful. Constipation might be accompanied by bloating and nausea. 

There are a few different reasons why you might have constipation. One is proctitis, which is an inflammation of the rectum. You might be absorbing water naturally in your digestive process, but if your rectum is inflamed, your stool will have difficulty passing through and you may subconsciously avoid initiating bowel movements. 

Other causes include a low-fibre diet, low water intake, certain medications, damage to the anal muscles from childbirth or surgery, and a stricture (narrowing of part of your intestine).

If your constipation is due to inflammation, sometimes better control of inflammation with anti-inflammatory medications can help reduce the problem. If you are currently taking medication for Crohn’s disease or colitis, but have persistent constipation, your physician may need to test for inflammation and consider other treatment options. Visit our Diagnosis and Testing section for more information.

In addition to medication for your Crohn’s or colitis, here are a few general ways to help manage your constipation: 

• Drink more water.

• Exercise more.

• Increase the amount of fibre you eat. If you are on a low-fibre diet and/or have a stricture, speak to your dietitian or gastroenterologist before making any changes to your fibre intake. 

• Try a bulking agent such as psyllium (Metamucil) or a laxative such as Lactulose, but first speak with a member of your IBD team. 

• Try not to hold in your stool, and refrain from straining while on the toilet.

If there is a mechanical cause affecting the flow of your stool, such as stricture, then you may need a surgical or endoscopic procedure to widen the passage.

To learn more about strictures in IBD, visit our Complications and Extraintestinal Manifestations section.

Sometimes people with constipation develop anal fissures or hemorrhoids

Anal fissures are small painful tears or sores in the lining of the anus. Hemorrhoids are swellings around the anus that contain enlarged blood vessels.

Find out more about these conditions in our Complications and Extraintestinal Manifestations section.