Can Crohn's Cause Constipation?

Understanding the Unexpected Symptoms

If you’re here, you might be navigating the often confusing and overwhelming world of Crohn's disease. As someone who has faced this devastating journey for over a decade, I can tell you that it’s filled with ups and downs, and one unexpected symptom I encountered was constipation. It’s a topic that’s not often discussed or understood, but it’s just as important to address as the more well-known issues like diarrhoea. Adding the Crohn's layer to IBS like symptoms, gives a level of complexity that not many professionals (or patients) understand.

My Experience with Constipation

When I first received my diagnosis of Crohn's disease, I thought I had a good handle on what to expect. I had heard plenty about the frequent bathroom trips and the unpredictability of bowel movements. However, one day, I found myself in a situation that felt entirely foreign—days without a bowel movement, accompanied by discomfort and bloating. It left me feeling helpless and frustrated, as I had thought that my main concern would be the opposite.

I remember discussing this with my doctor, who gently explained that, yes, Crohn's can cause constipation. It was a relief to know I wasn’t alone in this experience, but I also realized it meant I had more to learn about managing my symptoms.

Why Does Crohn's Disease Cause Constipation?

1. Strictures and Narrowing

Crohn's disease can lead to strictures in the intestines, which is a narrowing that can make it difficult for stool to pass. I learned that this physical change could create blockages, resulting in constipation. This is why sometimes the common advice of 'eat more fibre' can be bad. However, on the flip side, fibre is one of the things that feeds good gut bacteria, who then release anti-inflammatory compounds (Butyrate), which can then reduce narrowing that is caused from inflammation. This is why it can be so confusing!

2. Medication Effects

Many of us with Crohn's rely on medication to manage our symptoms. While these medications can be lifesavers, some, particularly opioids, can lead to constipation as a side effect. The pain cycle is a very interesting topic and I advise if you are in extreme pain to talk to a range of health care professionals. Some will provide prescriptions, some will work on breaking the cycle of pain, and some might advise you on how to use your mind to increase your level of tolerance. If you need help with who to contact (what fields) please reach out.

3. Dietary Factors

Managing what I eat has been essential, but it can be tricky. Certain high-fiber foods that are generally considered healthy can sometimes aggravate my symptoms, while others help with regularity. It took time and careful observation to find what works best for me but generally very well processed fibre rich foods (such as pureed into a sauce or blended in smoothies) is what worked best for me to get that right balance. Prebiotics can feed good bacteria, and may not have the same bulking effect if you start slow and increase the dosage by minuscule amounts.

4. Dehydration

Like many people with Crohn's, I’ve experienced dehydration, particularly during flare-ups. A lack of adequate fluid intake can lead to hard stools, making them difficult to pass. Staying hydrated is now a top priority for me. Lately I have been making a hydration solution at home to increase my electrolyte intake. The commercial ones seemed filled with chemicals (which my Crohn's does not respond well to).

Managing Constipation with Crohn's

Over time, I’ve discovered several strategies to help manage constipation, which I’d like to share with you:

1. Hydration Is Key

Drinking plenty of water has become a daily ritual for me. Staying hydrated is crucial in keeping my digestive system functioning as it should.

2. Mindful Eating

I’ve learned to listen to my body. Keeping a food diary has helped me identify which foods contribute to my symptoms and which ones support my digestion. Soluble fiber, found in foods like oats and bananas, tends to work better for me.

3. Gentle Exercise

Incorporating light physical activity into my routine has made a significant difference. Even a short walk can stimulate my digestive system and help ease constipation. There are many yoga exercises that can stimulate the bowels.

4. Regular Check-Ins with My Medical Support Team

I make it a point to discuss any changes in my symptoms with my healthcare providers. They can provide personalized advice from all walks of life and adjust treatments as needed to help manage side effects like constipation.

5. Massage

I use self massage and massage from others to move blockages through my intestines. It's also nurturing and nourishing in a time when pain can be high and comfort levels are low. 

6. Enema's

Enemas are a last resort but when I do them I use an empty medical enema bottle (washed out) and fill it with saline. Sometimes ill use 5 or 6, lay on the floor in the shower, and massage the blockage through. It takes some getting used to. I found the large 1000ml enema bags really clunky and uncomfortable to use.

7. Lactulose

This is a prebiotic and a laxative. Because it’s a prebiotic it feeds good bacteria. As a laxative it moves your bowels and stimulates going to the bathroom. This is my number one tip for helping with constipation because it balances the microbiome at the same time. There is a trick to introducing it though. Go slow and start at a very low dose. My constipation guide has all the details on where to start, what signs to look out for, and how to know when to increase the dosage. 

Questions Many People Ask

Is Constipation Common in Crohn's Disease?

Yes, constipation can be common among individuals with Crohn's disease, even though it’s often overshadowed by diarrhea. It’s important to recognize and address it.

What Are 5 Symptoms of Crohn's Disease?

The symptoms of Crohn's can vary widely but commonly include abdominal pain, diarrhea, fatigue, weight loss, and, as we’ve discussed, constipation.

Can You Poop Normally with Crohn's?

It is possible to have normal bowel movements while living with Crohn's, but this can vary from person to person. Many experience fluctuations, with periods of regularity followed by flare-ups.

Can Colon Inflammation Cause Constipation?

Yes, inflammation in the colon can lead to constipation. The inflammation can disrupt normal bowel function, resulting in difficulty passing stool.

Navigating the challenges of Crohn's disease can be daunting, especially when symptoms like constipation arise unexpectedly. Remember that you are not alone in this journey. Many of us have faced similar struggles and found ways to cope and manage our symptoms.

Sharing our experiences can be empowering, and I encourage you to reach out to support groups or fellow individuals with Crohn's. Together, we can explore strategies that help us live more comfortably and confidently.

As we learn to understand our bodies better, we become stronger advocates for our health. By addressing the less-discussed aspects of Crohn's, like constipation, we can create a more complete picture of what it means to live with this condition. Take it one day at a time, and remember that there is always hope and support available.