Cancer-Related Constipation
What is constipation?
Constipation is when you have infrequent bowel movements and stool that may be hard, dry, and difficult to pass. You may also have stomach cramps, bloating, and nausea when you are constipated.
What causes constipation?
Cancer treatments, such as chemotherapy, can cause constipation. Certain medicines (such as pain medicines), changes in diet, not drinking enough fluids, and being less active may also cause constipation.
What are some ways to prevent or treat constipation?
There are steps you can take to prevent constipation. It is easier to prevent constipation than to treat its complications, which may include fecal impaction and bowel obstruction.
Fecal impaction may be caused by using laxatives too often, using certain types of pain medicines, little or no physical activity over a long period, diet changes, or constipation that is not treated. Signs and symptoms may include being unable to have a bowel movement, pain in the abdomen or back, problems urinating, and nausea and vomiting. Fecal impaction may also cause problems with circulation, the heart, or breathing.
A bowel obstruction is a partial or complete block of the small or large intestine that keeps food, liquid, gas, and stool from moving through the intestines in a normal way. Bowel obstructions may be caused by a twist in the intestines, hernias, inflammation, scar tissue from surgery, and certain types of cancer, such as cancers of the stomach, colon, and ovary. They may also be caused by conditions that affect the muscles of the intestine, such as paralysis. Signs and symptoms may include pain and swelling in the abdomen, constipation, diarrhea, vomiting, and problems passing gas. Most bowel obstructions occur in the small intestine. Also called intestinal obstruction.
Here are some steps you can take to prevent or treat constipation:
Eat high-fiber foods. Adding bran to foods like cereals and smoothies is an easy way to get more fiber in your diet. Ask your healthcare team how many grams of fiber you should have each day. If you’ve had an intestinal obstruction or intestinal surgery, you should not eat a high-fiber diet. A dietitian can suggest foods to help relieve constipation.
Drink plenty of liquids. Most people need to drink at least eight cups of liquid each day. You may need more based on your treatment, medications you are taking, or other health factors. Drinking warm or hot liquids may also help relieve constipation.
Try to be active every day. Being active can help prevent and relieve constipation. Talk with your healthcare team about how active you should be and what kind of exercise to do. Most people can do light exercise, even in a bed or chair. Other people choose to walk or ride an exercise bike for 15 to 30 minutes each day.
Learn about medicine. Use only medicines and treatments for constipation that are prescribed by your doctor, since some may lead to bleeding, infection, or other harmful side effects in people being treated for cancer. Keep a record of your bowel movements to share with your doctor or nurse. Let them know if you have not had a bowel movement in two to three days. Your doctor may suggest a fiber supplement, laxative, stool softener, or enema. Do not use any of these products without first asking your doctor or nurse.
What questions should I ask my healthcare team about constipation?
You can prepare for your visit with your doctor by making a list of questions to ask. Consider adding these questions to your list:
- What problems should I call you about?
- What information should I keep track of and share with you? (For example, you may be asked to keep track of your bowel movements, meals that you have, and exercise that you do each day.)
- How much liquid should I drink each day?
- What steps can I take to feel better?
- Would you give me the name of a registered dietitian who can tell me about foods that might help?
- Should I take medicine for constipation? If so, what medicine should I take? What medicine should I avoid?
The Bottom Line
Constipation can be very uncomfortable and cause distress. It’s easier to prevent constipation than to relieve it. Prevention and treatment are not the same for everyone. If you are undergoing cancer treatment, talk with your doctor about what you can do to prevent constipation.
Source: National Cancer Institute, cancer.gov (September 2021)
