Managing Constipation on GLP-1s Guide

Constipation (having fewer than 3 bowel movements per week) is a common side effect of GLP-1 medications. Research shows that nearly 1 in 4 people taking a GLP-1 medication experience constipation, especially when they first start treatment or increase their dose.

This side effect is usually temporary. GLP-1 medications slow down how quickly food moves through your digestive system. This helps you feel full longer, but it can also cause constipation, nausea, and acid reflux while your body adjusts.

Regular bowel movements are important for your digestive health. If you are constipated, the following steps may help.

First Step: Diet and Lifestyle Changes

Drink Plenty of Fluids

GLP-1 medications can make you feel less thirsty, so it is important to drink enough water each day.

Your body also needs enough sodium to help hold onto that water. Adding a small pinch of salt to 16–32 ounces of water may help keep you hydrated. Some people also choose electrolyte products such as LMNT or Redmond's Real Salt.

Increase Your Fiber Slowly

Fiber helps move food through your digestive system. It also makes stool softer and easier to pass.

Good sources of fiber include:

  • Fruits
  • Vegetables
  • Beans and lentils
  • Whole grains
  • Nuts and seeds

Increase your fiber slowly over several days or weeks. Adding too much fiber too quickly can cause gas or bloating. You can read more about fiber here.

Be sure to drink plenty of water when increasing fiber. Without enough water, fiber can actually make constipation worse.

Stay Active

Physical activity helps your bowels move more regularly.

Helpful activities include:

  • Taking a brisk walk after meals
  • Gentle exercise
  • Deep belly breathing exercises

Even a few minutes of movement each day can help.

Second Step: Over-the-Counter Treatments

These treatments are meant for short-term relief. If you need treatment for more than 7 days, please contact the Calibrate Clinical Team.

Use only one of these treatments at a time. Stop using these products and contact your healthcare provider if you develop rectal bleeding or if they do not produce a bowel movement.

Magnesium Citrate

Magnesium citrate helps pull water into the stool, making it easier to pass.

  • Powder forms are often better tolerated than liquid forms for GLP-1-related constipation.
  • A typical starting dose is 200–400 mg daily.
  • Some people may need 600–800 mg daily, but higher doses can cause diarrhea.
  • Increase your dose by 200mg/day every 1-3 days as needed to a maximum dose of 800mg/day.
  • If your stools become too loose, lower the dose.

Magnesium citrate should only be used temporarily. Using it for a long time may cause your body to depend on it or lead to high magnesium levels.

Milk of Magnesia

Taking 1–2 tablespoons before bed often helps produce a bowel movement the next morning. You may use it for a few days to help relieve constipation.

Do not take magnesium supplements while using Milk of Magnesia.

Stool Softeners

If you are having bowel movements but your stools are hard, an over-the-counter stool softener such as docusate (Colace) may help. Continue drinking plenty of fluids while taking stool softeners.

MiraLAX®

MiraLAX is available over the counter and works by pulling water into the stool to make it softer. Take according to the manufacturer’s instructions.

Third Step: Prescription Treatment

If constipation continues, your GLP-1 medication dose may need to be adjusted for a short time. Please contact your Calibrate Clinical Team to discuss your symptoms.

There are also prescription medications that treat chronic constipation. These medications are not prescribed through the Calibrate program. If you think you may need additional treatment, talk with your primary care provider or another healthcare professional.

When to Contact the Calibrate Clinical Team

Please contact us through the Support Center in the app if:

  • You have questions about constipation or its treatment.
  • Your symptoms are not improving.
  • Your constipation is getting worse.

When to Seek Urgent Medical Care

Seek medical care right away if you have any of the following:

  • No bowel movement for 7 days or longer
  • Complete inability to pass stool or gas
  • Severe abdominal swelling with pain, nausea, or vomiting
  • Blood in your stool or rectal bleeding
  • Vomiting material that looks or smells like stool
  • Fever, a fast heart rate, or signs of dehydration

These symptoms may be signs of a more serious medical problem and should be evaluated as soon as possible.