Does prednisone cause constipation?

In this article:

• Prednisone and constipation
• Prednisone side effects
• Managing constipation
• When to see a doctor

In this article

• Prednisone and constipation
• Prednisone side effects
• Managing constipation
• When to see a doctor

Prednisone is a commonly prescribed corticosteroid medication used to treat various inflammatory conditions, such as ulcerative colitis, inflammatory bowel disease (IBD), and severe allergic reactions. While prescription steroid use can be effective in treating these medical conditions, patients often have questions about possible side effects, particularly when it comes to digestive issues like constipation.

Can prednisone cause constipation?

While it’s possible that taking prednisone can indirectly lead to some stopped-up feelings, constipation isn’t established as one of the medication’s primary potential adverse effects. “Constipation is not one of the side effects we commonly associate with prednisone, at least not in the official lists or clinical trials. That said, in real life, I have seen it happen,” advises James Lyons, MD, Physician at Synergy Houses in Austin, Texas.

That’s because the relationship between prednisone and constipation is an indirect one, explains Austin Shuxiao, MD, Founder and Medical Director at Peach IV. Prednisone can promote sodium and water retention, which could cause mild to moderate constipation depending on the individual.

It’s also possible that the source of the slowdown is behavioral: Reduced movement, a reduction in water or food intake, or even taking other medications can also lead to bathroom backups. The same is true when it comes to other corticosteroids. “Most of the gastrointestinal issues we look out for with these drugs are related to stomach irritation or changes in appetite,” Dr. Lyons says.

Save up to 80% on Prednisone with SingleCare

Different pharmacies offer different prices for the same medication. SingleCare helps find the best price for you.

Prednisone 20 mg (10 Tablets)

23666 - Hampton, VA

$3.15

i Price with signup

Get free coupon

$3.15

i Price with signup

Get free coupon

See Prednisone prices at all pharmacies

What are the most common side effects of prednisone?

While many people tolerate prednisone well, understanding its potential side effects can help you know what to expect and when to contact your healthcare provider. Fortunately, most short-term effects are manageable, and being aware of what to avoid can help minimize your risk of complications.

Short-term side effects

• Insomnia: People often feel energized and jittery on prednisone, which may lead to difficulty sleeping at night if taken late in the day.
• Mood changes: It is common for people to have mood changes while on prednisone, especially anxiety or irritability.

• Upset stomach: Patients are advised to take prednisone with food to avoid indigestion and nausea.
• Weight gain: Prednisone increases appetite and fluid retention, which can lead to extra pounds, especially around the torso.
• Hyperglycemia: Many people taking prednisone experience a moderate to severe increase in blood glucose levels. 

Long-term side effects

When it comes to prednisone, the side effects of long-term use are more generally more severe. If you experience any of these serious side effects, consult a healthcare professional:

• Changes in fat distribution: Body fat may redistribute to places like the abdomen, neck, or face.
• High blood pressure: With continued use, prednisone and other steroid medications are associated with high blood pressure.
• Thinning of the skin: Over time, skin can become thin and easily bruised, and cuts may heal more slowly than usual.
• Increased infection risk: Because prednisone suppresses the immune system, you may be more prone to infections.
• Muscle weakness: Over time, prednisone can reduce muscle mass and increase general fatigue.
• Adrenal suppression: If you take a high dose of prednisone or other glucocorticoids for more than 2-3 weeks, the adrenal glands can stop producing cortisol.

What to avoid while taking prednisone

It may sound obvious, but it’s important to avoid foods, drugs, or activities that may worsen the already present side effects of prednisone. Dr. Lyons also emphasizes the importance of staying active: “The main thing is to stay moving. Some people feel a little drained or restless on prednisone, but gentle activity like walking can help with mood, digestion, and sleep.” Additionally, avoid the following:

• Excessive salt: Prednisone can raise blood pressure and cause fluid retention, elevating the effects of salt.
• High-calorie or fatty foods: An excess of calories can lead to excessive weight gain or other metabolic disturbances.
• Added sugars: Since prednisone can lead to high blood sugar levels, it’s important to watch out for added sugars in the diet.
• Grapefruit: Grapefruit juice inhibits the enzyme that metabolizes prednisone, which can cause the steroid to build up and amplify its side effects.
• Alcohol: Prednisone is converted to its active form, prednisolone, by the liver. Since alcohol metabolism also occurs in the liver, it’s best to avoid mixing the two.
• NSAIDs: Taking NSAIDs with prednisone increases the risk of stomach irritation or even bleeding.
• Fluoroquinolones: Broad-spectrum antibiotics taken in conjunction with prednisone have been linked to an increased risk of tendon rupture in older adults.

How to relieve constipation from prednisone

If you’re feeling a little slow to go, Dr. Shuxiao recommends taking the same approach as you would to non-prednisone-related constipation: “Drink more water, take a laxative, eat more fiber, get plenty of exercise, and if none of them help, then you can try a suppository laxative or even an enema.”

Staying well-hydrated is crucial when taking prednisone. Aim for at least 8-10 glasses of water daily unless your healthcare provider has given you specific fluid restrictions. Consider adding fiber-rich foods to your diet, such as fresh fruits and vegetables, whole grains, legumes and beans, and prunes or other dried fruits.

If that’s not enough, over-the-counter options may help relieve digestive plumbing problems. Fiber supplements like psyllium husk or methylcellulose, stool softeners such as docusate sodium, and gentle laxatives like polyethylene glycol can all help relieve irregularities. If you do end up using a laxative while taking prednisone, it’s important that you monitor for any potential electrolyte imbalance, adds Dr. Shuxiao.

When to see a healthcare provider

While occasional constipation may not be a cause for immediate concern, certain situations warrant medical attention. If it has been more than three days since your last bowel movement, it is time to seek professional medical advice, Dr. Lyons says.

Some other important signs to look out for:

• Severe abdominal pain that does not go away
• Painful, rigid abdominal wall
• Vomiting, especially if the vomit is green/bile-like or smells like stool
• Blood in the stool
• Trouble passing gas
• Feeling uncomfortably full apart from after a meal

If constipation becomes severe or lasts a long time, it can cause electrolyte imbalances in the body, which require medical intervention. One last disclaimer: Straining to have a bowel movement can be especially risky for older individuals.

Talk with a healthcare provider about alternative treatment options if you continue to experience unpleasant side effects while taking prednisone. Your healthcare provider may be able to adjust your dosage, recommend specific treatments for constipation, or suggest dietary modifications to help manage your symptoms.