What can cause a constipation with a stoma and how to manage it

Constipation is something many people with a stoma experience at some point. For some, it may only happen occasionally, while for others it can be more frequent.  Although it can feel uncomfortable — and sometimes painful — understanding why it happens and what you can do about it can make it easier to manage and, in many cases, prevent.

What can lead to constipation?

Constipation can develop for several reasons, and not all of them are directly linked to having a stoma. 

Some of the more common causes include: 

A diet that is low in fibre or lacks variety
Not drinking enough fluids
Reduced physical activity
Certain medications, including some pain relief and antidepressants

Being aware of these factors can help you identify what might be contributing to changes in your stoma output.

Ways to relieve constipation

If you are experiencing constipation, there are some simple steps that are often recommended as a starting point. 

Increasing your fluid intake is important, as this helps keep stool softer and easier to pass. Alongside this, adding more fibre-rich foods to your diet — such as wholemeal bread, wholegrain pasta, fruit and vegetables — can help support regular bowel movement.  

These changes can often make a noticeable difference. 

If constipation continues despite adjusting your diet and fluid intake, it’s a good idea to speak with your stoma care nurse or another healthcare professional for further advice.

Using laxatives: what to be aware of

It’s common to wonder whether laxatives can help when constipation occurs.

However, for people with a stoma, laxatives need to be used with caution. They can sometimes lead to a rapid loss of fluids and electrolytes, which may cause further complications.  

For those with an ileostomy, laxatives are generally not recommended. 

In some situations, people with a colostomy who are experiencing more severe constipation may be advised to use a mild laxative. This should only be done under guidance from a healthcare professional. 

Before using any laxative, it’s always best to speak with your stoma care nurse or GP.

Reducing the risk of constipation

Preventing constipation often comes down to a few everyday habits. 

Helpful steps include: 

including more fibre-rich foods in your meals, such as whole grains and porridge
eating a variety of fresh fruit and vegetables
drinking enough fluids throughout the day to stay well hydrated

If you are making changes to your diet, it can help to do so gradually. This allows your body time to adjust and may reduce the chance of discomfort such as wind or bloating.

Taking a steady approach

Constipation can be uncomfortable, but it is often manageable with small adjustments to your routine. 

By paying attention to your diet, fluid intake and activity levels, you can support your body and reduce the likelihood of it becoming a regular problem. 

And if something doesn’t feel quite right, reaching out to your stoma care nurse or healthcare professional can help you find the right support.