Aspirin and Constipation: Side Effect and Management

Aspirin can include constipation among its possible side effects, although it is not among the most common gastrointestinal issues associated with the drug. ^[1] Constipation is listed in comprehensive side‑effect information for oral aspirin, alongside other stomach-related effects. ^[2]

How Often Does Constipation Occur with Aspirin?

• Constipation appears as a potential adverse effect in authoritative patient and professional monographs for aspirin. ^{[1] [2]}
• More frequently reported digestive side effects with aspirin and other NSAIDs include indigestion (dyspepsia), abdominal pain, nausea, and diarrhea, which tend to occur more often than constipation in clinical summaries. ^{[3] [4]}

In practice, constipation from aspirin seems less common than indigestion or diarrhea, but it can still happen for some people. ^{[3] [4]}

Why Might Aspirin Lead to Constipation?

• Aspirin can irritate the stomach lining and alter normal bowel function, which may contribute to changes in stool pattern such as constipation or diarrhea. ^{[3] [4]}
• Individual factors like low fluid intake, reduced activity, or diet changes can make constipation more likely when starting a new medicine. While these are not aspirin-specific, they can interact with any medication’s GI effects. ^{[5] [6]}

If you notice new or worsening constipation after starting aspirin, the timing can be a clue that aspirin may be playing a role. ^{[1] [2]}

Warning Signs That Need Prompt Medical Attention

• Black, tarry stools, vomiting blood or material that looks like coffee grounds, severe or ongoing stomach pain, unusual bleeding or weakness these can signal bleeding in the stomach or intestines and need immediate medical evaluation. ^{[7] [2]}
• Marked changes in stool color (e.g., very light) or significant abdominal pain should also be discussed with a clinician. ^[8]

Constipation alone is usually not dangerous, but constipation with bleeding, severe pain, or black stools is a red flag. ^{[7] [2]}

Practical Ways to Cope with Constipation

Lifestyle steps

• Hydration: Aim for regular water intake so your urine stays pale yellow; adequate fluids soften stool. ^[5]
• Fiber: Include fruits (like apricots, figs, raisins), vegetables, beans, nuts, and whole grains to help stool move. ^[5]
• Routine and movement: Try to use the bathroom shortly after meals (especially breakfast) to use your natural colon reflex, and keep up gentle exercise such as walking. ^[6]

Consistent hydration, daily fiber, and a bathroom routine after meals are simple, effective habits. ^{[5] [6]}

Over‑the‑counter options

• Stool softeners (e.g., docusate) can make stool easier to pass and are generally well tolerated. ^[9]
• Other laxatives may be considered short‑term if lifestyle steps are not enough; discuss choices and dosing with your healthcare provider to avoid overuse. ^[10]

Start with a stool softener if needed, and add other laxatives only after discussing them with your clinician. ^{[9] [10]}

When to call your clinician

• No bowel movement for about 3 days despite self‑care, or constipation accompanied by new bleeding, severe abdominal pain, or concerning symptoms. ^{[11] [7]}

If constipation persists or you see blood, contact your clinician rather than self‑treating further. ^{[11] [7]}

Considering Aspirin Dose and Alternatives

• If constipation started after a dose change, your clinician may consider adjusting the dose or timing, balancing heart/stroke prevention benefits with side effects. ^[7]
• For those needing long‑term antiplatelet therapy, a clinician can review risks and benefits and discuss supportive measures for GI tolerance. ^[7]

Do not stop aspirin on your own; any change should be guided by your clinician given its cardiovascular benefits. ^[7]

Bottom Line

• Constipation can occur with aspirin, though it is not among the most frequent GI side effects compared with indigestion, abdominal pain, nausea, or diarrhea. ^{[1] [3]}
• Most cases improve with fluids, fiber, movement, and occasional use of stool softeners, but seek medical help for red‑flag symptoms like black stools, bleeding, or severe pain. ^{[5] [9] [7]}