Semaglutide constipation: causes, duration, and tips for relief

Semaglutide, the active ingredient in Wegovy, Ozempic, and Rybelsus, is known to cause a variety of gastrointestinal side effects. Though nausea is the most common side effect, feeling backed up and struggling to go number two is also a known issue. The good news? Semaglutide constipation is usually temporary, and there are steps you can take to help prevent or relieve the discomfort of infrequent bowel movements or hard-to-pass stool.

Keep reading to learn more about the connection between semaglutide and constipation — plus, five tips for getting rid of it.

Yes, semaglutide can cause constipation. Semaglutide, the active ingredient in Wegovy, Ozempic, and Rybelsus, caused constipation in clinical trials of all three drugs. Up to 24% of people on Wegovy experienced constipation compared to 3%--5% of people on Ozempic and 5%--6% of people on Rybelsus.

Semaglutide side effects like constipation are often dose-dependent, which means they are more common at higher doses. Given that, people on the highest doses of Wegovy, Ozempic, and Rybelsus — 2.4 mg injected weekly, 2 mg injected weekly, and 14 mg taken orally daily, respectively — tend to be most likely to experience semaglutide constipation than those on lower doses.

Being constipated for any length of time can be frustrating, but fortunately, semaglutide constipation tends to get better with time as your body adjusts to the medication. Still, if you have questions about side effects or experience severe or unrelenting constipation while on Wegovy, Ozempic, or Rybelsus, consult your healthcare provider for personalized medical advice.

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Researchers don’t know precisely why semaglutide and constipation can often go hand-in-hand, but they theorize that it’s related to how the medication impacts your digestive system. 

Semaglutide is a glucagon-like peptide-1 receptor (GLP-1) agonist that delays gastric emptying, i.e. the movement of food from your stomach into your intestines. Slowing down your digestive system can be a good thing for blood sugar control and weight loss (the things GLP-1s are used for!), but a sluggish digestive process can also contribute to constipation. 

Another possible reason semaglutide causes constipation? Inadequate hydration. Delayed gastric emptying means you feel satisfied with less food, which might lead to reduced eating and drinking.  Not getting enough fluids can cause constipation characterized by hard, lumpy stools that are difficult or painful to pass.

Finally, nausea — the most common side effect of semaglutide medications — may indirectly lead to constipation. The reason is simple: Most people reach for bland, low-fiber foods like plain rice or toast when they feel sick. Bland foods are great for quelling that sick-to-your-stomach sensation, but they’re often low in fiber, and inadequate fiber intake can cause constipation. That’s because fiber adds bulk to your stool and helps it retain water, making it easier to pass. 

Good news: Semaglutide constipation is usually temporary. Although experiences vary from person to person, the median duration is about 47 days. In general, semaglutide side effects tend to improve and even disappear as your body gets used to the medication. Meaning, patience is often key when it comes to semaglutide constipation. (That’s not to say there aren’t additional tactics for easing backed-up bowels — but more on that soon.) 

It’s worth noting that while semaglutide constipation tends to lessen with time, it can also come and go. As mentioned above, semaglutide side effects tend to be dose-dependent; the higher the dose, the more likely you are to experience the common symptoms of gastrointestinal distress. So you might experience more constipation when you first start the medication and after dose increases. Remember: Semaglutide dosing follows a titration schedule, wherein your healthcare provider gradually increases your dose until finding one that delivers the desired effects without too many side effects.

Gastrointestinal problems are no picnic, but they’re often an unfortunate reality for many people taking semaglutide. For instance, it’s not uncommon to feel sick on Wegovy or have sulfur burps on Ozempic. When it comes to semaglutide constipation, there are several things you can do to cope while your body gets used to the medication.

Stay hydrated

Drinking more water can help soften stool to make bowel movements smoother. Unfortunately, drinking enough fluids can be tricky if you’re experiencing nausea or other digestive distress on semaglutide. You might find it more comfortable to slowly sip water throughout the day rather than drinking a big glass at mealtimes. Some people also make their water more appealing by adding a squeeze of lemon or lime. You can also boost hydration slightly with water-rich foods like watermelon, cucumber, soup, or even popsicles made from pureed fruits and vegetables.

If you’re concerned that semaglutide side effects like nausea and vomiting are making it feel impossible to stay hydrated, consult your healthcare provider. 

Focus on fiber

Remember, not getting enough dietary fiber can cause hard, lumpy stool and constipation. Increase your fiber intake with fiber-rich foods like beans, lentils, broccoli, sweet potatoes, and high-fiber breakfast cereals (e.g. varieties with shredded wheat and bran flakes). 

Fiber is most effective when paired with water, as water helps the fiber pass smoothly through the digestive system. So, try your best to stay well-hydrated by sipping water or other non-sugary drinks shortly before or after getting your daily fill of fiber. 

Don’t forget to exercise

Whether you are taking semaglutide for type 2 diabetes or weight loss, GLP-1s are intended to be used in conjunction with a healthy diet and regular exercise. In addition to helping you reach your health goals, exercise is often used to relieve constipation. Researchersaren’t 100% clear on why physical activity can relieve constipation. But it’s possible that working out — especially by doing aerobic exercises (e.g. swimming, walking, cycling) —  can improve colon motility and such body movement can help mechanically move stools toward the rectum. 

Consider over-the-counter treatments

Some people turn to over-the-counter(OTC) laxatives or stool softeners to help with semaglutide constipation. However, it’s important to consult a healthcare professional first. 

If you are considering an OTC laxative to help relieve semaglutide constipation, it’s a good idea to ask your healthcare provider for advice on which OTC treatment might be best (and safest) for you. There are many types of laxatives, ranging from those that help soften hard stools or lubricate the stool and intestines for easier passage to those that actually stimulate the intestinal muscles to contract, pushing stool through the digestive tract. 

Talk to your healthcare provider about dosage

If GI side effects like constipation are unbearable or interfering with your daily life, tell your healthcare provider. Remember, semaglutide constipation and other side effects are dose-dependent — they occur more often at higher doses — so you might need a dose adjustment. If adjusting your semaglutide dose still doesn’t relieve your constipation, your healthcare provider may recommend a different treatment. 

Tell a healthcare provider right away if any of the following symptoms accompany your constipation:

• Severe stomach pain

• Abdominal swelling

• Rectal bleeding

• Inability to pass gas

• Vomiting 

These symptoms could indicate a more serious gastrointestinal issue that requires medical treatment. 

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Does semaglutide make you constipated? In some cases, yes. Let’s recap:

• Semaglutide may cause mild-to-moderate, temporary constipation. In clinical trials of Wegovy, a semaglutide medication, up to 24% of participants reported experiencing constipation. In general, semaglutide constipation tends to be mild to moderate and typically lasts a median of 47 days, as the body adjusts to the medication. 

• Gastrointestinal side effects of semaglutide are dose-dependent. GI side effects like constipation tend to occur most frequently in people taking higher doses. 

• Semaglutide slows gastric emptying, which may also result in slower or less frequent bowel movements. Decreased fluid and fiber intake due to appetite reduction and nausea may also contribute to semaglutide constipation.

• Lifestyle changes can help prevent or alleviate constipation. Staying hydrated, eating more fiber-rich foods, and exercising can help relieve constipation. In some cases, OTC laxatives might also be helpful. 

• Tell your healthcare provider if constipation and other side effects are severe or persistent. Your dosage might need to be adjusted, or your provider might recommend additional treatments or switching to a new treatment.