When it comes to the most persistent symptoms of Crohn’s disease, diarrhea is at the top of the list. However, this is not always the case for individuals coping with this chronic condition. Constipation is also an issue.
The large intestine is responsible to reabsorbing water from foods that are digested. If the intestine absorbs a larger quantity of water, passing stool can become much more difficult. Constipation is defined as difficulty passing stool or passing stool less than three times a week. As a result, it can cause a few unwanted symptoms, including abdominal bloating, cramping, and nausea.
What causes constipation in Crohn’s disease?
The main factors that often lead to constipation include not consuming enough fluids, not eating enough, eating a low-fiber diet, ignoring the need to make a bowel movement, taking certain medications, and lacking in physical exercise. Moreover, constipation mainly affects older individuals, women, who are more prone to the condition, individuals taking certain medications or having undergone surgery, as well as individuals with medical conditions that affect the hormones.
Many individuals with Crohn’s disease avoid high-fiber foods as they tend to irritate their stomachs. They may also not be drinking enough liquids to avoid the persistence of diarrhea. For this reason, constipation is not uncommon among individuals with Crohn’s.
Living with chronic constipation
“When I was first diagnosed with Crohn’s, I was making up to 25 trips to the bathroom daily. I had the hardest time trying to control having to go so many times, and staying hydrated was a struggle. A lot of that changed when I had a hemicolectomy. One section of my colon was so diseased it was wreaking havoc and I was getting obstructions. After that portion was removed, I still was making numerous trips, although fewer. Fast-forward two years, and now I live with the opposite problem, chronic constipation. My doctor told me that although it’s less common, the reason for my constipation is Crohn’s disease. After some testing, my doctor found a large section of my colon is moderately inflamed before the anastomosis site and has stopped moving. Although there really isn’t a way to get that section to start functioning normally again, there are some ways to help” wrote Lisa Burk, in her column Finding the Silver Linings.
Constipation may be normal from time to time; however, chronic constipation can interfere with an individual’s everyday life and can become dangerous. Constipation is considered chronic when symptoms are persistent for a period of three months and treatment depends on the underlying cause.
What to do if you’re experiencing chronic constipation with Crohn’s
If you have Crohn’s disease and you are experiencing constipation, either temporary or chronic, this may be a result of your daily water intake, diet, medications, or sedentary lifestyle. To ease constipation, speak with your doctor about making a few diet and lifestyle changes.
- Include more high-fiber foods (fruits, vegetables, beans, whole-wheat breads, cereals, oatmeal, etc.) in your diet to speed up bowel movement in the intestines, as long as these aren’t trigger foods. Try to avoid processed foods, fast food, and dairy
- Increase your intake of liquids (vegetable juices, soups, etc.) to stimulate the proper flow of bowel movements. Try to avoid caffeine and alcohol
- Exercise on a regular basis to increase activity in your intestines. Move around whenever you can by walking instead of driving or taking the stairs instead of taking the elevator
- Take a gentle laxative for constipation to speed up bowel movement. Talk with your doctor about which laxative is right for you as there are different ones and each works in a different way:
- Bowel irritants prevent water from being reabsorbed and make stool easier to pass
- Lubricants help make the stool smoother
- Osmotic agents retain water in the intestine, making stool easier to pass
- Bulking agents absorb water and cause an increase in stool mass that is easier to pass
- Take prescription medications to treat chronic constipation. Talk with your doctor about what type of medication is right for you and see if your condition improves
Other tips that you might find useful include:
- Drink some prune juice
- Increase your fat intake
- Add some salt to your food
- Try acupuncture
- Eat foods that work for your metabolic type
- Try flax seed oil or sprinkle some flax seeds onto your food
- Drink some herbal teas (such as chamomile)
- Do not wait if you have an urgent need to go to the bathroom
“I tried several non-prescription options to help with my chronic constipation, but never experienced much relief. I live with many symptoms, including nausea, feeling of fullness, and cramping. My doctor prescribed Linzess because the problem is my intestines are not moving anymore. I don’t get great relief, but some is better than none! I also found adding the over-the-counter laxative Miralax on top of the prescription medication has helped. I am only able to do this with my doctor’s recommendation. As I have said numerous times before, always stay in communication with your doctor. He or she will be able to give you safe options to obtain relief from constipation, but first needs to narrow down the possible causes before starting treatments” wrote Lisa Burk.
How sudden constipation is different
Keep in mind that it is possible for Crohn’s disease to trigger the sudden onset on constipation. This may be an indication of a more severe problem, such as intestinal blockage or narrowing of the intestine caused by severe inflammation. The most common symptoms of intestinal blockage include nausea, high fever, vomiting, severe abdominal pain and cramping, constipation, and the inability to pass gas. For this reason, it is important to have open conversations with your doctor about your condition and any symptoms that you are experiencing. He or she will likely ask you about your personal and family medical history, how often you have been experiencing infrequent bowel movements, whether you have noticed any blood in your stools, what symptoms you are experiencing, what your daily food intake looks like, whether anything relieves or worsens your constipation, and what type of medications you are taking.
While these questions may seem a bit personal, this is the only way that your doctor can get to the bottom of finding the right type of treatment plan for you. Do not feel embarrassed or afraid to ask a few questions yourself about what types of food or beverages you should consume on a daily basis, what type of laxative will work best for your condition, how soon you can expect alleviation of your symptoms, and when you should come in for a follow-up appointment.
“I will talk about my bowel movements with anyone who'll listen. Using toilet humor and talking about my poo normalizes my Crohn's disease. It helps me accept the fact that I will be living with this disease for the rest of my life. There's a sense that 'girls don't poo' and 'girls don't fart' so it's hard for them to be open about their symptoms and many women feel ashamed and suffer in silence as a result, but digestive disorders are common and there's no reason for people to feel alone or embarrassed” wrote Carly Gordyn, a student at Australian National University (ANU).
If you have Crohn’s, then you need to make your health your priority. You need to feel comfortable talking openly with your doctor about your condition so that he or she can monitor your health and you can receive the best care possible. Together, you can determine if the recommended treatment plan is working for you as proper management is key to your health outcome.