Constipation and Cancer Treatment

What constipation isExplain▾

Constipation is the slow movement of stool (poop) through the large intestine, the long tube that carries waste out of your body. The longer stool takes to move through, the more fluid it loses and the drier and harder it becomes.

If you are constipated, you may be unable to have a bowel movement, need to push harder than usual, or have fewer bowel movements than normal. Constipation may last a short time, or it may be chronic and last for a long time.

Tell your doctor if you have constipation. They can recommend medicines and other ways to treat it. Treating it early also helps prevent more serious problems.

Signs and symptomsExplain▾

Signs and symptoms of constipation include:

• having two or fewer bowel movements in one week
• dry, hard, or lumpy stool
• pain during a bowel movement
• difficulty having a bowel movement
• stomach pain or cramps
• feeling bloated or nauseous

What causes itExplain▾

Constipation in people with cancer may be caused by:

• Certain types of cancer. Constipation can be a sign of cancers that press on organs in the belly, block the movement of stool, or affect the nerves connected to the bowel.
• Cancer treatments such as chemotherapy. Constipation is a common side effect of some types of chemotherapy.
• Medicines. Many medicines can cause constipation, including opioid pain medicines, anti-anxiety drugs, anti-nausea drugs, and diuretics.
• Lifestyle and diet changes. During treatment you may have less energy for exercise, and your appetite and diet may change. Being less active and eating differently can lead to constipation.

How it is diagnosedExplain▾

Finding the cause helps you get relief and avoid serious problems. Your doctor will do a physical exam, looking at and feeling your belly and listening to your bowel sounds. They may ask how often you have bowel movements, when your last one was and what it was like, and whether you have fever, cramps, pain, or bloating.

Sometimes your doctor may do other tests, such as a digital rectal exam (feeling inside the lower rectum with a gloved finger) or an x-ray of the belly, which can show a tumor or impacted stool.

Ways to prevent and ease itExplain▾

If your doctor expects your cancer or treatment to cause constipation, they may give you tips and prescribe medicine to prevent it. Many of the same steps help if you become constipated.

Everyday tips:

• Drink plenty of liquids. About 8 cups of water or clear liquids a day helps. Coffee and prune juice can have a laxative effect, and hot drinks can help stool move.
• Try to be active every day. Walking, riding a bike, or gentle yoga may be options. You can also do light exercise in a bed or chair. Ask your team what is right for you.
• Eat at the same time each day. A regular routine can help return you to your usual number of bowel movements.
• Keep a record of your bowel movements. Sharing this with your team helps them treat the problem.
• Ask about fiber before adding it. High-fiber foods and fiber supplements can make constipation worse for some people, so check with your doctor first.

Medicines your doctor may recommendExplain▾

Your doctor may prescribe laxatives to prevent or relieve constipation. Use only medicines and treatments your doctor recommends. Common types include:

• Osmotics, which pull water into the bowel to make stool easier to pass.
• Stool softeners, which soften stool by adding water and fat.
• Stimulant laxatives, which cause the intestines to contract so stool moves along.

Do not use suppositories or enemas unless your doctor recommends them. In some people with cancer, these can cause bleeding, infection, or other harmful effects.

When constipation becomes seriousExplain▾

Long-term constipation can lead to fecal impaction, a serious condition in which hardened stool blocks the colon or rectum. Unlike ordinary constipation, fecal impaction can be life-threatening and needs immediate medical attention.

Signs of fecal impaction include ongoing constipation, a feeling of pressure or incomplete emptying, back or belly pain, changes in urination, nausea and vomiting, and sometimes sudden diarrhea leaking around the blockage. Treating constipation early helps prevent it.

Getting supportExplain▾

Side effects like constipation can be hard to deal with, both physically and emotionally. It's important to ask for support from your health care team. If you are caring for someone with cancer, you can help by encouraging fluids, supporting gentle activity, keeping track of bowel movements, and telling the care team about warning signs.