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Diabetes and Constipation: What You Need to Know

Medically Reviewed by Michael Dansinger, MD on April 23, 2020

Diabetes may set you up for digestive system problems like constipation, but there are many things you can do to get relief.

While everyone is different, some signs that you are constipated are:

  • You poop fewer than three times a week
  • Your bowel movements are hard, dry, or lumpy
  • You have to strain to go
  • You feel bloated
  • Your stomach hurts

Anyone can get constipated. But when you have diabetes, you get changes to your body that can make constipation more likely.

Autonomic Neuropathy

A set of nerves called your autonomic nervous system controls things like your breathing, heartbeat, and digestion. Over time, out-of-control diabetes can damage your nerves. About half of people who have diabetes also have nerve damage, called neuropathy.

When diabetes damages the nerves that control digestion, you have trouble moving food through your system. You can end up with a combination of symptoms, including vomiting, bloating, diarrhea, and constipation.

Other Causes of Constipation

Poor diet. Many people get diabetes because they don't eat enough of the right kind of food. A poor diet can also make you constipated. Your body needs lots of insoluble fiber to have regular bowel movements. You get this kind of fiber from whole grains, fruits, and vegetables. If you cut down on carbs to help lower your blood sugar, you may also be cutting out important fiber sources.

Dehydration. Diabetes makes your kidneys work overtime trying to flush the extra sugar out of your bloodstream. You have to pee more often, which can leave you dehydrated. That makes your bowel movement harder than it should be, and your body has trouble getting it through your system.

Medications. Many drugs can make you constipated, including several that doctors prescribe to people with diabetes. That includes opioids for the pain of peripheral neuropathy, anticholinergics for bladder control, and calcium channel blockers to lower blood pressure.

How to Get Things Moving

Your first goal should be to get your blood sugar under control. That can delay or prevent more nerve damage in your intestines. As it turns out, many of the healthy choices that doctors recommend to help manage diabetes will also ease constipation:

  • Eat food that's high in fiber, like whole grains, fruits, and vegetables.
  • Get regular exercise.
  • Drink plenty of water.

Fiber supplements can help deliver what you don't get from your diet alone. They make your bowel movements larger and softer so they're easier to pass. Laxatives, either over-the-counter or prescription, are another option. They either pull water into your intestines, to soften your bowel movements, or force your intestines to contract and move them along.

Talk to Your Doctor

Keep your doctor updated about your diabetes symptoms. They may recommend you eat smaller meals more often to help your digestion.

Get your doctor's OK before you try laxatives. Some contain a lot of sugar, which can be dangerous with diabetes. Laxatives can make other digestive symptoms worse, like bloating. And not all of them are meant to be used long-term.

Also, ask your doctor whether any drugs you're taking might be making your constipation worse, and whether there's an alternative.

WebMD Medical Reference

Sources

SOURCES:

National Institute of Diabetes and Digestive and Kidney Diseases: "Preventing Diabetes Problems," "Definition and Facts for Constipation," "Autonomic Neuropathy," "Diabetic Neuropathy," "Symptoms & Causes of Constipation," "Diabetes Diet, Eating, & Physical Activity," "Treatment for Constipation."

Diabetes Therapy: "A Practical Approach to Gastrointestinal Complications of Diabetes."

Current Treatment Options in Gastroenterology: "Diabetes Mellitus and the Colon."

American Family Physician: "Gastrointestinal Complications of Diabetes."

Diabetes Care: "Diabetic Autonomic Neuropathy," "Gastrointestinal Symptoms in Diabetes: Prevalence, Assessment, Pathogenesis, and Management."

Diabetes.co.uk: "Constipation and Diabetes," "Risk Factors for Type 2 Diabetes," "Dehydration and Diabetes."

American Diabetes Association: "Neuropathy," "Eating doesn't have to be boring."

Indian Journal of Gastroenterology: "Management of chronic constipation in patients with diabetes mellitus."

Mayo Clinic: "Laxative (Oral Route.)"

American Academy of Family Physicians: "Laxatives: OTC Products for Constipation."

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