GLP-1 Constipation Tracker: What to Log on Ozempic

If you take semaglutide (Ozempic, Wegovy) or tirzepatide (Mounjaro, Zepbound), constipation is worth tracking on purpose. A simple log of bowel movements, stool type, the gaps between them and dose change dates turns “I feel more blocked up” into something your prescriber can work with. The log is a record for that conversation and does not diagnose anything.

Constipation on Ozempic, Wegovy, Mounjaro and Zepbound

Constipation is listed among the most common adverse reactions in the FDA prescribing information for all four medicines. In the label trial tables, it was reported by 24% of adults on Wegovy 2.4 mg injection versus 11% on placebo, 11% to 17% on Zepbound versus 5%, 6% to 7% on Mounjaro versus 1%, and 3.1% to 5% on Ozempic versus 1.5%, depending on dose. The trials studied different groups, so these numbers do not rank the medicines.

The labels also say these medicines delay gastric emptying and list postmarketing reports of ileus, intestinal obstruction and severe constipation including fecal impaction. For Ozempic, Mounjaro and Zepbound, they note that most nausea, vomiting or diarrhea came during dose escalation, one more reason to keep dose dates beside your log.

What to log for GLP-1 constipation

Log each bowel movement soon after it happens:

• Date and time
• Bristol stool type from 1 to 7. Types 1 and 2 are hard lumps and suggest constipation, while types 3 and 4 are the usual comfortable range
• Straining, and a feeling that not all stool has passed
• Belly pain or bloating, and how strong it was
• Any blood

Once a day, add water, main meals and fiber-rich foods, and anything unusual such as travel or illness. Keep the medicine start date and every dose change on a separate list, since dose dates are hard to rebuild later.

How to read your own pattern

The NIDDK describes constipation as fewer than three bowel movements a week, hard, dry or lumpy stool, stool that is difficult or painful to pass, or a feeling that not all stool has passed. The NHS also counts pooing less often than usual, so your own baseline is the best comparison.

Count bowel movements per week and how many were type 1 or 2. Compare with a typical week before you started the medicine or before the last dose change. Without earlier records, your first weeks of logging become the reference. A shift that repeats after each dose step says more than one hard week.

A short summary for your prescriber

The NIDDK diagnosis page says doctors ask how often you have a bowel movement, how long symptoms have lasted, what stools look like, and about diet, activity and medicines, and suggests tracking bowel movements for several days or weeks before the visit. A one-page summary can cover:

• Medicine, start date and dose change dates
• Bowel movements per week before and after, and the longest gap
• How often stool was type 1 or 2, and how often you strained
• Belly pain, bloating, water and diet changes
• Any blood in stool, vomiting or other warning signs

Dose changes, laxatives and other treatment are questions for your prescriber. This article does not give that advice.

When to get medical help promptly

The Medication Guides say to call your healthcare provider right away for severe stomach pain that will not go away, with or without vomiting, sometimes felt through to the back. They also say to tell your provider right away about nausea, vomiting or diarrhea that does not go away, since fluid loss can lead to dehydration and kidney problems, and to report severe or lasting stomach problems. Upper belly pain with fever, yellowing skin or eyes, or clay-colored stools can signal gallbladder problems.

The NIDDK lists bleeding from the rectum, blood in stool, constant belly pain, inability to pass gas, vomiting, fever and lower back pain as reasons to see a doctor right away. Signs of dehydration include dark yellow, strong-smelling pee, peeing less often and dizziness. A diary should never delay care. This article is general information, not medical advice.

How bellySignal helps

bellySignal is a self-recording diary, not a medical device. It does not diagnose, tell you what caused a symptom or track your medicine.

• Log each bowel movement with time, Bristol stool type 1 to 7, color, blood or mucus, and toggles for urgency, straining and incomplete emptying.
• Log belly pain and bloating on a 1 to 7 scale, water toward a daily goal with your own cup size, food and habits such as coffee, alcohol, dairy, spicy food, stress and poor sleep, plus supplements, weight, sleep, stress and mood.
• The day timeline shows what came before and after a hard or loose stool.
• Trends show how often you went and your stool form this week, compared with your usual over the previous four weeks.
• Export a 90-day PDF summary to show a clinician.

It is free, with no subscription, on iPhone and Android in 15 languages. Your diary is stored on your device, and you can start without an account. Some health values, such as stool type, symptoms and manually entered weight, are also sent to PostHog analytics, which is on by default. The analytics switch in settings controls PostHog only. Firebase Analytics receives usage events without those health values. Privacy policy.