Constipation with cystic fibrosis CF (1305)

Constipation is a common problem in people with cystic fibrosis.  Constipation is when:

• The stool (poop) is hard to pass. 
• There is less stooling than normal.
• The stools are smaller than normal. 
• There may be frequent stomach aches.
• If you are concerned about constipation, you should call your CF doctor or CF nurse.  

What causes it?

Constipation can be caused by:

• Thick sticky mucus lining the intestinal wall.
• Not enough liquid in the diet.
• Too much caffeine. 
• “Holding” stool.
• Changes in routine or stress, like traveling, starting school, or starting a new job.
• Missing enzymes or taking too few enzymes.
• Fever, illness, or dehydration.
• Hot weather.
• Not enough fiber in the diet.

What are the common symptoms?

• Feeling the urge to poop, but not being able to.
• Cramps.
• Bloating and gas.
• Decreased appetite.
• Stool leakage or soiling.
• Nausea.
• Diarrhea mixed with pieces of formed stool.
• Alternating formed and liquid bowel movements.
• Hard, dry or large, wide stools.

How is it diagnosed?

You’ll be asked about your symptoms, diet, health, and daily routine.  An x-ray may be done before treatment is started.  A second x-ray may be needed to make sure the constipation has improved after treatment.

How is it treated?

The care provider can talk to you about treatment options.  Your child may need to: 

• Empty the bowel (colon):  A medicine called polyethylene glycol (Miralax®) may be used.  Your care provider may recommend mixing a large amount of polyethylene glycol with water, juice, or sports drink.  
• You may feel better after passing one or more larger stools, but there is still a lot more to pass.  The constipation may have cleared when you start passing only liquid stool with no pieces.  If you have finished the amount of mix prescribed above and still are passing solid stools, call your CF care provider for more instructions.
• For daily use:  Take the amount of polyethylene glycol with water, juice or sports drink recommended by your care provider. Continue taking it to prevent constipation from happening again.  
• Eat more fiber. Fiber is found in most whole grains, fruits, and vegetables.  It adds bulk and absorbs water to soften stool.  This helps stool pass through the colon more easily.  
• Drink more liquids.  Drinking water and fruit juice can help soften stool. Avoid caffeine. It can be dehydrating. 
• Be active. Moving around and exercising can help the colon work better and ease constipation. 

Cystic Fibrosis Center         
Children’s Wisconsin            
414-266-6730

For other health and wellness information, check out this resource: https://kidshealth.org/ChildrensWi/en/parents