GLP-1 medications — Ozempic, Wegovy, Mounjaro, Zepbound and the rest — are everywhere in 2026. The nausea gets all the press. But talk to people a few months in and a quieter complaint keeps coming up: constipation. Gastroenterology coverage this month, including a new report in Medscape, confirms what patients have been saying on every GLP-1 forum — constipation is one of the most common GI complaints among people taking these drugs, and published analyses of GLP-1 trials back it up.
If you have hemorrhoids, or you've ever had them, that matters. Here are the questions we keep hearing, answered plainly.
These drugs work partly by slowing down your digestive tract. Slower gastric emptying is the point — it keeps you full longer. But the slowdown doesn't stop at the stomach. Food moves through the colon more slowly too, and the longer stool sits in the colon, the more water gets pulled out of it. Add in the fact that most people on GLP-1s are eating a lot less — less food, less fiber, often less fluid — and you get stool that is smaller, harder, and harder to pass.
Everything. Hard stool and straining are the classic setup for a hemorrhoid flare. When you push against a stool that won't move, pressure spikes in the veins of the rectum and anus. Do that daily for weeks and existing hemorrhoids swell, and new ones can form. Constipation is one of the best-established aggravators of hemorrhoids in the medical literature — this isn't a stretch, it's the textbook mechanism.
Two problems, two plans. For the constipation: water first — many people on GLP-1s drastically under-drink because they never feel hungry or thirsty. Then fiber, added gradually (a sudden fiber load on a slowed gut means bloating). Movement helps; even a daily walk stimulates the colon. If that's not enough, ask your prescriber about a stool softener or gentle laxative — they handle this question constantly, and there are options that pair well with GLP-1s.
For the flare itself, the goal is comfort while the irritation settles. A warm 10–15 minute soak with a sitz bath soak once or twice a day relaxes the area and eases that deep ache. For sharp pain, a topical like our Advanced Hemorrhoid Cream — 5% lidocaine for numbing plus phenylephrine to reduce swelling — gives temporary relief of the pain, burning and swelling so you can get through the day. And swap dry toilet paper for a gentle cleansing lotion; scrubbing an inflamed area with dry paper keeps it inflamed.
Not on your own. For most people, GLP-1 constipation is manageable with fluids, fiber, movement and, when needed, a doctor-recommended softener. If constipation is severe or you're going many days without a bowel movement, that's a conversation with your prescriber — they can adjust dosing schedules or add treatment. Don't quit a medication that's working over a side effect that usually responds to management.
Build the routine before the problem: a fiber target you actually hit (add slowly — vegetables, oats, chia, or a supplement), a water bottle you finish even when you're not thirsty, a daily walk, and answering the urge to go instead of postponing it. On the toilet, no marathon phone sessions and no straining — if nothing happens in a few minutes, get up and try later. Keep supplies on hand so a bad day doesn't become a bad week: a 5% lidocaine numbing cream in the cabinet beats a drugstore run mid-flare.
See a doctor for rectal bleeding that is more than streaks on the paper, bleeding with dark or mixed-in blood, severe pain with a hard lump, fever, or a flare that isn't improving after about a week of care. And loop in your prescriber about the constipation itself — it's a known, managed side effect, not something to white-knuckle.
This article is for informational purposes only and is not medical advice. Talk to your doctor about your symptoms, your medications, and before starting any new treatment.