When Constipation Becomes a Crisis: What GLP-1 Users Need to Know
- Jennifer Hardy
- Sep 9
- 7 min read
Most people know that GLP-1 medications can cause gastrointestinal issues. Constipation gets mentioned about as often as diarrhea, so I wasn’t surprised by the possibility. What I didn’t realize was how severe it could get if life threw me a little off balance.
After nine months without a problem, I suddenly found myself in a situation that nearly sent me to the ER—not from injury, but from something far more embarrassing. Moving stress, disrupted meals, and a change in routine created the perfect storm. And the result was a level of constipation I didn’t know was possible.
That’s why I’m writing about it. Not because it’s easy to share, but because no one should feel blindsided by how intense this side effect can become. Ideally, my oversharing will help you avoid being stuck on the toilet with no solution in sight. And if you do end up in trouble, hopefully, this guide will help.
My Constipation Catastrophe
I thought I knew what constipation meant. I’d read the warnings, heard other people’s stories, and figured I was in the clear after nine months without a problem. But stress, grief, and a cross-country move had me off my normal routine. My fridge was empty, my meals were improvised at restaurants, and my body was out of rhythm.
Then one day, the urge hit. At first, it felt like business as usual, but once I sat down, nothing happened. It wasn’t that my body didn’t want to go. It was that everything seemed stuck in limbo. I tried to convince myself it wasn’t time yet, but the second I stood up, I realized there’s no turning back once the urge kicks in. Nothing was moving forward, nothing was retreating.
It felt like a giant dam had slammed shut inside me. Pushing seemed risky, sitting there felt pointless, and standing up wasn’t an option. I was trapped in a moment I’d never imagined possible, and the only way out was going to be uncomfortable, awkward, and unforgettable.
Without getting too detailed, it was the square-peg/round-hole analogy: bathroom edition. I'm not one to ever get too worried about an injury or health issue, but I was scared. Would I sit on this toilet for the rest of my life? If I told anyone, I would be the "butt" of jokes for years to come.
Searching for Immediate Constipation Relief
Since I had all the time in the world and nowhere to go, I turned to the phone for some "incognito search mode" help. I laugh now, thinking that I just wanted to avoid constipation ads for the next two weeks or that some Google bot was going to tell everyone I was trapped on the toilet in a literal shitstorm.
The solutions weren't helpful at first.
Drink more water: Too late for that.
Add fiber to your diet: If I eat anything right now, I'm certain I will explode from the gluteus maximus.
Take a laxative: Not fast enough, and I feared the power of a rush of water coming in behind the boulder trapped in my butthole.
There wasn't a good Google answer for "trapped on the toilet with intense constipation." That's because I wasn't dealing with just constipation. I was facing fecal impaction.
Constipation vs Fecal Impaction
Constipation is uncomfortable, but it usually means things are just moving slowly. Maybe you haven’t gone for a couple of days, maybe what does come out is hard and difficult to pass. Annoying, yes. Dangerous, not usually.
Fecal impaction (aka impacted bowel), on the other hand, is when stool has built up so much that it creates a full-on roadblock. Your body keeps sending signals that it’s time to go, but nothing is coming out because the passage is literally blocked. That’s why the usual advice — drink more water, eat more fiber, wait for a laxative — doesn’t work once you’ve reached that point.
In other words, constipation is a delay; fecal impaction is a dead stop. And it’s important to know the difference, because ignoring impaction can turn a humiliating bathroom episode into a real medical emergency.
Everything I read said "go to the emergency room" because this could get really dangerous, really quickly. Only I couldn't move. Couldn't drive. And didn't have anyone to ask for help around me.
The Warning Signs of Impacted Bowel
While I know all the side effects of GLP-1s, such as tirzepatide, I've learned a lot in the days since my toilet troubles. In fact, several studies show that while rare, fecal impaction is a potential problem with these digestion-slowing medications.
Let's "back up" and not all the warning signs I missed or didn't know to look for.
1. Constipation lasting several days
Not just one skipped day, but multiple days without a full bowel movement. As well as I tracked my diet and side effects on Zepbound, the stress of the upcoming move lowered that priority. I had no idea when my last bowel movement was.
2. Abdominal discomfort or bloating
Pressure, cramping, or swelling in your stomach area can signal a blockage building. Of course, those are also side effects of Zepbound (and Ozempic/Wegovy). Especially since I was eating out more (albeit with healthy options), I did feel bloated, but I assumed it was due to the increase in diet soda and sodium from restaurant-prepped meals.
3. Straining with no progress
When pushing feels ineffective or even risky, that’s more than everyday constipation. A few times, I remember thinking it was time to go, but pleased when it was "just number 1" since I had so much to do.
4. Leakage or watery stool
Sometimes liquid seeps around the blockage, which can be mistaken for diarrhea. Totally normal when you're on a GLP-1 diet, you think, until you reach that horrible point of no return.
5. Loss of appetite or nausea
Your body’s way of saying the system is backed up and unhappy. Again, my uncharacteristic food habits, increase in soda, and Zepbound side effects made me write this off. Plus, it was never intense or severe enough to stop me from getting work done.
6. Not Enough Fiber
I was eating “healthy” but probably overcorrected too much on protein during the move without measuring fiber intake. Fiber is the bulk and softness that keeps bowel movements regular. Without it, things can literally grind to a halt.
How To Manage Immediate Fecal Impaction
I’m not a doctor, and if you’re ever in doubt, the safest choice is to head to urgent care or the ER. Fecal impaction can be serious, and waiting too long can make things worse. But if you find yourself in the kind of urgent, no-choice situation I did, there are a few options people commonly use at home to get past the worst of it.
Manual Removal: Sometimes the only way forward is hands-on. If you reach this point, use a clean, gloved hand and a water-based lubricant. Gently break up or remove enough of the blockage to let your body do the rest, not to cause injury by forcing it.
Enemas and Suppositories: Over-the-counter enemas or glycerin suppositories can help soften and lubricate the blockage so it passes more easily. They work faster than oral laxatives, which are often too slow once impaction has already set in.
Warm Water with a Bidet or Shower Head: Directing a gentle stream of warm water toward the rectal area can help relax the muscles, ease discomfort, and sometimes encourage the blockage to shift. A bidet attachment can make this easier, but even a handheld shower head aimed carefully can help. This method isn’t as fast as an enema, but it doesn't take nearly as long as an oral laxative.
While I hope you never end up having to make this choice, having these items on hand can alleviate a lot of stress during a painful situation.
What to Avoid During Fecal Impaction
When you’re stuck in the middle of a fecal impaction, instinct takes over. Unfortunately, some of those instincts can make things worse. Here are a few things you don’t want to do:
Don’t just sit and push. Straining hard doesn’t move a blockage. It only increases your risk of hemorrhoids, tears, or even fainting from the pressure.
Don’t keep eating more food. Adding more “bulk” on top of a blockage only piles on and can worsen the pressure and pain.
Don’t chug oral laxatives and wait. They work too slowly once impaction has set in, and the extra water can create painful pressure behind the blockage.
Don’t ignore the situation. Hoping it resolves on its own can lead to bigger problems. If nothing changes within hours, medical help is the safest route.
The Fecal Impaction Aftermath
The bottom line: once you realize you’re facing impaction, it’s not about pushing harder or waiting it out. It’s about using safe methods to clear the blockage or knowing when it’s time for medical care.
Even if you manage to clear the blockage at home, there are times when you shouldn’t just move on and forget about it. Call your doctor if you notice:
Bleeding that’s more than a small streak or doesn’t stop quickly.
Persistent pain or cramping after the impaction passes.
Nausea, vomiting, or fever, which can signal infection or a more serious obstruction.
Recurring impactions, even if you manage them yourself — that’s a sign something bigger needs attention.
One tough bathroom episode can be an accident of stress, diet, or routine. It's always better to share your concerns with a medical provider, even if the immediate issue (quite literally) passes.
How to Avoid Fecal Impaction on GLP-1s
The best way to deal with fecal impaction is to never let it happen in the first place. That means paying attention to the basics your gut depends on.
Get enough fiber. Aim for 25–30 grams a day from a mix of fruits, vegetables, beans, whole grains, or a fiber supplement if needed. Too much protein without enough fiber is a recipe for trouble.
Stay hydrated. Shoot for 2–3 liters of water daily (8–12 cups). On GLP-1s, hydration matters even more because digestion slows and stool dries out faster.
Keep track. Know when you last had a bowel movement. It sounds simple, but awareness can keep “constipation” from sneaking up until it’s an emergency.
Move your body. Even light daily activity can stimulate digestion and keep things moving.
Fiber is the bulk, water is the lubricant, and routine is the rhythm. When those three fall apart — from stress, grief, travel, or just life — your gut pays the price. As I've mentioned before, I also use a digestive enzyme and probiotic daily, but again, my habits were off during my move, and I figured I'd buy more when I got to my new place. Never again will I risk constipation that turns into a crisis.
I never thought I’d be writing about this, but my constipation catastrophe taught me that this side effect deserves more than a passing mention in the fine print. Talk to your doctor, make the daily adjustments you can, and don’t wait until you’re stuck in the most uncomfortable situation imaginable to take it seriously.
