Managing Constipation
GLP-1 medications slow digestion, which can lead to constipation. Learn prevention strategies and treatment options to stay comfortable.
Educational Purposes Only
This information is provided for educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment. Always consult your healthcare provider before starting, stopping, or modifying any treatment or medication.
Why It Happens
GLP-1 medications work by slowing gastric emptying and reducing gut motility. While this helps with appetite control and blood sugar management, it can also slow down bowel movements, leading to constipation. Prevention is key—if left uncontrolled, constipation can cause blockages, hemorrhoids, and significant discomfort.
Prevention: Lifestyle & Dietary Modifications
Increase Fluid Intake
Drink plenty of water throughout the day. Adequate hydration helps soften stool and promotes regular bowel movements. Aim for at least 8 glasses of water daily.
Increase Daily Fiber
Aim for 20-25 grams of fiber per day from fruits, vegetables, whole grains, and legumes. Note: Effects may take several weeks, and bloating/flatulence is common initially.
Stay Active
Regular physical activity helps stimulate bowel function. Even light walking for 20-30 minutes daily can make a difference.
Step-by-Step Treatment
Follow these steps in order. If one approach doesn't work, move to the next level.
*Please consult your healthcare provider before starting new OTC medications.
Start with Bulk Laxatives
If lifestyle and dietary changes don't help after 1-2 weeks, add a bulk-forming laxative:
- Metamucil (psyllium): 1 tablespoon in 8 oz water, 1-3 times daily
- FiberCon: 2 tablets up to 4 times daily
- Benefiber: 2 teaspoons in liquid, 1-3 times daily
💡 Tip: Start with a lower dose and gradually increase to minimize gas and bloating.
Add MiraLAX
If bulk laxatives alone don't provide relief:
- MiraLAX (polyethylene glycol 3350): 17 g (1 capful) mixed in 4-8 oz of liquid once daily
- Can be used safely with fiber supplements
- Works by drawing water into the colon to soften stool
Add Stool Softeners
If needed, add a stool softener to your regimen:
- Docusate sodium (Colace): 100 mg twice daily
- Can be taken daily with other agents
- Works by allowing water and fats to penetrate stool
For Immediate Relief: Stimulant Laxatives
Use only as needed for severe constipation (not daily):
- Senna: Follow package directions
- Dulcolax (bisacodyl): 5-15 mg as needed
⚠️ Important: Stimulant laxatives should only be used occasionally, not as a daily treatment.
Last Resort: Enemas
For severe constipation lasting more than several days:
- Tap water enema or Fleet enema
- Helps prevent fecal impaction
- Use only when other methods have failed
When to Seek Medical Care
Contact your healthcare provider or seek immediate medical attention if you experience:
- Severe abdominal pain
- No bowel movement for more than 7 days despite treatment
- Vomiting
- Blood in stool
- Severe bloating or distention
- Unable to get relief despite following these recommendations
Quick Tips
- Start prevention strategies as soon as you begin GLP-1 medication
- Don't wait until constipation becomes severe
- Keep a bowel movement diary to track patterns
- Establish a regular bathroom routine (same time each day)
- Don't ignore the urge to have a bowel movement
- Warm liquids in the morning can help stimulate bowel movement
References
- Nauck MA, et al. Incretin hormones: Their role in health and disease. Diabetes Obes Metab. 2018;20 Suppl 1:5-21. https://pubmed.ncbi.nlm.nih.gov/29364588/
- Bharucha AE, et al. Mechanisms, evaluation, and management of chronic constipation. Gastroenterology. 2020;158(5):1232-1249.e3. https://pubmed.ncbi.nlm.nih.gov/31945360/
- American Gastroenterological Association. Medical Position Statement on Constipation. Gastroenterology. 2013;144(1):211-217. https://pubmed.ncbi.nlm.nih.gov/23261064/
- Suares NC, Ford AC. Systematic review: the effects of fibre in the management of chronic idiopathic constipation. Aliment Pharmacol Ther. 2011;33(8):895-901. https://pubmed.ncbi.nlm.nih.gov/21332763/
- Ford AC, et al. American College of Gastroenterology monograph on management of irritable bowel syndrome. Am J Gastroenterol. 2018;113(Suppl 2):1-18. https://pubmed.ncbi.nlm.nih.gov/29950604/