Constipation in Kidney Disease

Patient Leaflets Team

  • Reference Number: HEY1180/2020
  • Departments: Nutrition Support, Renal Service

What is constipation?

 Constipation is when you open your bowels (poo) less than usual or you are having a difficult time trying to push out a bowel motion (poo).

What are the signs and symptoms of constipation?

You may notice that your bowel motions become very large, hard, dry or lumpy. A normal bowel motion is one that is smooth and easy to pass.

Symptoms of constipation can include:

  • Feeling full or bloated
  • Feeling sick (nausea)
  • Stomach pains or cramps
  • Feeling less hungry than usual
  • Lacking in energy

Why do I have constipation?

There are many reasons why someone with kidney disease can develop constipation and these can include:

  • Fluid restrictions
  • Reduced activity or mobility
  • Dietary changes and poor fibre intake
  • Other medical conditions such as an under active thyroid, irritable bowel syndrome, etc.
  • Some medications such as certain pain relief medication such as codeine or morphine or certain medications needed when on dialysis
  • Stress, anxiety or low mood

Why is it important to avoid constipation?

If you are regularly pushing hard to have a bowel motion then you are more likely to develop haemorrhoids (piles) which can cause itching, pain and bleeding.

When you cannot move your bowels at all, the bowel motions can start to stick together in your intestines. The hardened mass gets stuck and causes a blockage. Sometimes this can then cause you to have very watery bowel motions and this is known as overflow diarrhoea.

If you are having peritoneal dialysis (PD), constipation can squash your PD tube or cause your PD tube to move and make it difficult for you to drain out dialysis fluid. In extreme cases it can be a reason to stop peritoneal dialysis and move to haemodialysis. For those having automated peritoneal dialysis (overnight), then you are more likely to experience ‘drain pain’ when the dialysis fluid is being drained from your abdomen.

How can constipation be treated?

Prevention is better than cure so it is best to avoid becoming constipated in the first place.  This can be done by:

  • Eating regular meals (avoid skipping meals)
  • Include some high fibre foods at each meal
  • Make sure you are having your full fluid allowance
  • Move about and exercise regularly if possible
  • Sit in the right position when using the toilet. Use a foot stool to bring your knees up (squat position).

Your doctor or nurse may suggest the use of medications such as laxatives to help your bowels. Take this as prescribed; do not wait to become constipated before using.

How do I increase fibre in my diet?

  • Choose a higher fibre breakfast cereal such as plain whole wheat biscuits or plain shredded whole grain. Porridge oats are also a good source of fibre.
  • Choose wholemeal or granary breads or higher fibre white bread and wholegrains like whole wheat pasta, bulgur wheat or brown rice.
  • Choose potatoes with their skins on such as boiled new potatoes
  • Add pulses like beans, lentils or chickpeas to stews, curries and salads.
  • Include plenty of vegetables with meals either as a side dish or added to sauces, stews or curries.
  • Have some fresh or dried fruit or fruit canned in natural juice for dessert.
  • For snacks try fresh fruit, vegetable sticks, rye crackers, oatcakes or unsalted nuts or seeds.
  • High fibre dietary supplements can be used to increase your fibre intake if changing your diet is difficult and you can discuss this with your Kidney Dietitian.

If you are following a low potassium diet or are taking a blood thinning medication called Warfarin then please contact your Kidney Dietitian for more individual advice on how to safely increase your fibre intake.

This information sheet has been provided by your healthcare professional to give you initial advice.  You can ask for a referral to the Kidney Dietitians for individual advice and support.

KIDNEY DIETITIANS

TELEPHONE:  (01482) 674707

EMAIL:              Renal.Dietitians@nhs.net

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