How to Avoid Constipation with Sucralfate

October 7, 2025 •

4 min read

Constipation is the most common side effect reported with sucralfate use, affecting a small but significant percentage of patients. Understanding why this happens is the first step toward implementing lifestyle changes and other measures to effectively manage and avoid constipation with sucralfate therapy.

Quick Summary

Sucralfate, while effective for treating ulcers, can cause constipation due to its binding action and effect on digestive tract motility. This article provides strategies to prevent and manage this side effect, including increasing fluid intake, boosting fiber consumption, incorporating regular exercise, and discussing appropriate over-the-counter remedies with a healthcare provider. It also covers when to seek medical advice for more severe symptoms.

Key Points

Hydration is Key: Drink 8-10 glasses of water daily to help soften stools, especially when increasing fiber intake.
Boost Fiber Intake: Consume a mix of soluble and insoluble fiber from fruits, vegetables, and whole grains to add bulk and moisture to your stool.
Stay Active: Regular exercise, like walking or cycling, stimulates intestinal muscle contractions, aiding bowel movements.
Time Sucralfate Properly: Take sucralfate on an empty stomach, at least an hour before meals, to ensure optimal effectiveness and avoid digestive interference.
Consider OTC Remedies: Over-the-counter options like osmotic laxatives (e.g., MiraLAX) or stool softeners (e.g., docusate) can help, but consult a doctor first.
Watch for Red Flags: Seek medical advice for severe or persistent symptoms such as pain, bleeding, or vomiting, as they could signal a more serious complication.

Understanding Sucralfate's Constipating Effect

Sucralfate is a medication prescribed to treat and prevent duodenal ulcers. It works by forming a protective coating over the ulcerated area, shielding it from stomach acid and digestive enzymes, which allows it to heal. However, this same binding action within the gastrointestinal tract can slow down the normal movement of fluids and waste, leading to constipation. Additionally, sucralfate contains aluminum, which is also a known constipating agent. As the medication is minimally absorbed by the body, the majority of it is excreted unchanged in the feces, which can also contribute to slower intestinal transit. Most people tolerate sucralfate well, but for those who do experience constipation, proactive management is key to maintaining comfort during treatment.

Proactive Dietary Strategies

Addressing constipation often begins with diet. By making simple changes, you can significantly improve bowel function while taking sucralfate.

Increase Your Fiber Intake

Fiber adds bulk and moisture to stool, helping it move more easily through the digestive system. There are two types of fiber: soluble and insoluble. Soluble fibers absorb water to form a gel-like substance, while insoluble fibers add bulk. Incorporating both into your diet is beneficial. Some high-fiber foods to consider include:

Fruits: Berries, apples, pears, and prunes. Prunes, in particular, contain sorbitol, a sugar alcohol with a natural laxative effect.
Vegetables: Broccoli, artichokes, beans, and lentils.
Whole Grains: Oatmeal, whole-wheat bread, and brown rice.

Stay Adequately Hydrated

Drinking plenty of fluids is crucial, especially when increasing fiber intake. Water helps soften the stool, making it easier to pass. Aim for 8 to 10 glasses (2 to 2.5 liters) of water or other non-caffeinated liquids each day. Sparkling water has shown some effectiveness in stimulating bowel movements for some individuals with chronic constipation, though sugary carbonated drinks should be avoided.

Consider Probiotics

Probiotics are beneficial bacteria that can help balance gut flora and improve digestion. Studies have suggested that probiotics may help alleviate medication-induced constipation. You can find probiotics in foods like yogurt, kefir, sauerkraut, and kombucha, or take a daily supplement.

The Role of Exercise and Lifestyle

In addition to dietary measures, certain lifestyle habits can promote regular bowel movements.

Incorporate Regular Physical Activity

Sedentary lifestyles are linked to a higher risk of constipation. Regular exercise, such as brisk walking, cycling, or swimming, can stimulate muscle contractions in the intestines, helping move waste through the colon. Even a gentle walk each day can be beneficial.

Optimize Medication Timing

For sucralfate to be most effective, it must be taken on an empty stomach, typically one hour before meals and at bedtime. It is also recommended to separate sucralfate doses from other medications and supplements by at least two hours. Food can interfere with sucralfate's binding action, reducing its efficacy. By adhering to these guidelines, you can ensure the medication works as intended while giving your digestive system time to process food separately.

Over-the-Counter Solutions for Constipation Relief

If lifestyle and dietary changes are not enough, several over-the-counter options can help manage constipation. However, always consult a healthcare professional before starting any new medication to ensure it is appropriate for you.

A Comparison of Common Constipation Remedies


Remedy Type	Example Product	How It Works	Onset of Action	Notes
Stool Softeners	Docusate (Colace)	Adds moisture to the stool, making it softer and easier to pass.	12-72 hours	Recommended for those experiencing straining.
Osmotic Laxatives	Polyethylene glycol (PEG, e.g., MiraLAX), Milk of Magnesia	Draws water into the colon, softening stool and increasing bowel movement frequency.	1-3 days for PEG.	Often preferred due to fewer side effects like cramping.
Stimulant Laxatives	Senna (Senokot), Bisacodyl (Dulcolax)	Stimulates the nerves and muscles of the intestines to increase contractions.	6-12 hours	May cause cramping and should not be used long-term without medical advice.

When to Consult a Healthcare Professional

While constipation from sucralfate is generally manageable, certain symptoms warrant a call to your doctor. These include:

Severe, persistent, or worsening constipation.
Continuous abdominal pain or bloating.
Rectal bleeding or blood in your stool.
Unintentional weight loss.
Inability to pass gas.
Nausea or vomiting.

These symptoms can sometimes indicate a more serious condition, such as a gastric bezoar formation, a rare but possible complication of sucralfate where a mass of undigested material blocks the bowel. Your doctor can recommend a specific treatment plan or adjust your medication if needed.

Conclusion

Constipation is a common but manageable side effect of sucralfate. By being proactive with hydration, increasing dietary fiber, staying active, and timing your medication correctly, you can often mitigate the issue. If these strategies aren't enough, safe over-the-counter options are available. The goal is to manage the side effect effectively so you can continue the medication and allow your ulcer to heal, without experiencing significant discomfort. For further guidance on sucralfate use, consult resources like MedlinePlus.

Frequently Asked Questions

Sucralfate causes constipation by slowing down the movement of fluids and waste in the digestive tract. It forms a protective barrier over ulcers and contains aluminum, both of which contribute to slowed digestion.

You should aim to drink 8 to 10 glasses (2 to 2.5 liters) of water or other non-caffeinated liquids per day. Staying well-hydrated is particularly important when you increase your fiber intake.

Yes, many over-the-counter laxatives can be used, but you should always consult your healthcare provider first. Osmotic laxatives (like MiraLAX) and stool softeners (like docusate) are often good starting points.

Good sources of fiber include fruits with edible skins, berries, vegetables, legumes like beans and lentils, and whole grains such as oatmeal and brown rice.

Yes, regular physical activity helps. Exercise can stimulate the muscles in your intestines, promoting more frequent and regular bowel movements.

You should contact your doctor if you experience severe or persistent constipation, abdominal pain, rectal bleeding, vomiting, or if you are unable to pass gas. These symptoms could indicate a more serious issue.

Probiotics, which are beneficial gut bacteria, may help by improving the balance of gut flora and aiding digestion. Consider incorporating probiotic-rich foods like yogurt or kefir, or a supplement.