Constipation in Crohn's disease: what to know

Crohn's disease can affect any part of the digestive tract. Constipation may reflect ordinary changes in fluid, fibre, movement or eating, but it can also occur when an inflamed or scarred area narrows the bowel. Some medicines, including certain pain medicines or iron supplements, may also make stools harder or less frequent.

Pay attention to your usual bowel pattern rather than a fixed number of bowel movements. Hard stools, straining, a feeling of incomplete emptying, new bloating or cramping are useful details. Abdominal pain, vomiting, marked swelling or inability to pass gas can signal a blockage and needs urgent assessment.

Record when the change began, stool texture, pain, vomiting, fever, gas passage and current medicines. Contact your gastroenterology team or a GP before taking a laxative if the constipation is new, persistent or accompanied by Crohn's symptoms.

Drink fluids as tolerated and keep gently active if your clinical team allows it. Do not suddenly add large amounts of fibre when a narrowing is possible, and do not stop prescribed Crohn's treatment without advice. A clinician may examine you, review medicines and arrange a blood test or other assessment.

Seek urgent care for severe or worsening abdominal pain, repeated vomiting, a swollen or firm abdomen, inability to pass stool or gas, faintness, or blood in the stool. These features can accompany obstruction, bleeding or significant inflammation.

Arrange prompt medical advice for constipation that is new, lasts despite simple measures, repeatedly returns, or occurs with weight loss, fever or a clear change in your Crohn's pattern. Bring your medicine list and note whether you can eat, drink and pass gas.

Could a medicine, flare or narrowing explain this change? Is fibre appropriate for me, and which bowel treatment is suitable with my Crohn's disease? Do I need an examination, blood test or imaging? Which symptoms mean I should attend urgent care?