From the Guidelines
Constipation is a common side effect of GLP-1 medications, and managing it requires a multifaceted approach that includes lifestyle modifications and potential over-the-counter medications, as evidenced by the gastrointestinal effects of GLP-1 receptor agonists discussed in 1. To manage constipation while on GLP-1 treatment, it is essential to increase fluid intake to at least 8-10 glasses of water daily and consume more fiber-rich foods like fruits, vegetables, and whole grains, aiming for 25-30 grams of fiber per day. Regular physical activity, even just walking for 30 minutes daily, can help stimulate bowel movements. Some key points to consider when managing constipation with GLP-1 treatment include:
- Increasing fluid intake to help soften stool and make it easier to pass
- Consuming more fiber-rich foods to help promote regular bowel movements
- Engaging in regular physical activity to stimulate bowel movements
- Considering over-the-counter options like osmotic laxatives, stool softeners, or stimulant laxatives for occasional use These medications work because GLP-1 agonists slow gastric emptying and intestinal transit as part of their mechanism of action, which contributes to weight loss but can lead to constipation, as noted in 1. If symptoms persist despite these measures, or if you experience severe abdominal pain or no bowel movement for more than 3-4 days, it is crucial to consult your healthcare provider as your GLP-1 dosage might need adjustment or additional prescription treatments may be necessary.
From the Research
Constipation with GLP-1 Treatment
- Constipation is a potential side effect of GLP-1 receptor agonists, which are used to treat type 2 diabetes 2, 3, 4.
- GLP-1 receptor agonists can slow gastric emptying, which may contribute to constipation 3.
- The effects of GLP-1 receptor agonists on gastric emptying can decrease over time due to tachyphylaxis 2, 3.
- Management of constipation in patients with diabetes, including those taking GLP-1 receptor agonists, typically involves dietary changes, exercise, and laxatives 5.
- Fiber supplementation, particularly with psyllium, can be effective in improving constipation symptoms 6.
Mechanisms of GLP-1 Receptor Agonists
- GLP-1 receptor agonists stimulate insulin secretion, suppress glucagon secretion, and slow gastric emptying 2, 3, 4.
- These mechanisms can help improve glycemic control and reduce the risk of cardiovascular events 2, 4.
- GLP-1 receptor agonists may also have beneficial effects on weight loss and renal function 2, 4.
Treatment of Constipation
- Dietary changes, including increased fiber intake, can help improve constipation symptoms 5, 6.
- Laxatives, such as bulking agents, osmotic agents, and stimulants, can be used to treat constipation 5.
- Fiber supplementation, particularly with psyllium, can be effective in improving constipation symptoms 6.