CONSTIPATION
What is constipation?
Constipation is defined as a condition in which bowel (stool) movements are rare, incomplete or there is difficulty in passing stool. No regular bowel movement for 3 days is described as constipation. Constipation is common for persons taking opioid (any medicine that contains opium, and has the quality of relieving pain) medications for their pain. Constipation also occurs for those with not enough fluid intake, not enough fiber intake, and who have low physical activity. Constipation can also occur from the cancer itself, chemotherapy or other drug therapies.
How do people describe constipation?
Many people have described constipation as an enlargement or bloating in the abdomen. Some feel a pressure or sense of fullness in the rectal area. Others describe small amounts of stool "leaking", small frequent "smears" of stool, or rectal pain with a bowel movement. Constantly feeling the need to have a bowel movement but unable to pass stool is another way to describe constipation.
What causes constipation?
The cause of constipation varies. Pain medication or chemotherapy drugs can cause constipation. Other changes include stress, fever, changes in diet, or low levels of physical activity. Constipation is common for those experiencing weakness, who spend a lot of time in bed, or are not eating well.
How do people cope with constipation?
Here are some tips people have found helpful:
Drink 8 (8 oz.) glasses of water or other non-caffeinated drinks every day.
Exercise every day; at least a 15 minute walk. Mild exercise, such as walking, helps.
Dont use suppositories or enemas without talking to your doctor.
Ask for a stool softener and/or laxative from your doctor or nurse.
Eat foods high in fiber such as raw vegetables, popcorn, raisin bran, beans, whole grain cereal, raisins and prunes.
Establish a bathroom routine every day with privacy to go to the bathroom.
Drink warm liquids such as lemon water, prune juice, or tea after mealtime.
Add unprocessed bran or wheat germ to your diet. Start with two teaspoons per day
and gradually increase to 2 tablespoons per day.
Avoid caffeine (ex. coffee) when possible; caffeine causes dehydration.
Try going to the bathroom after mealtime.
Pain medications with narcotics often cause constipation. Ask your doctor for a laxative if you take a narcotic for pain.
What can family members and friends do to help me with my constipation?
Ask family members and friends to prepare foods high in fiber.
Ask family members and friends to offer you fluids throughout the day.
Ask family members and friends to exercise with you.
How can I talk with my family members and friends about my constipation?
Request privacy to discuss your concerns.
Try to describe how the constipation makes you feel.
What should I report to my doctor or nurse?
Vomiting or abdominal bloating accompanied by constipation that lasts over 24 hours.
Inability to eat.
Spike of fever greater than 100.4º F associated with constipation.
If you havent had a bowel movement in 3-4 days.
Bloody or black tarry stools.
Severe, uncontrolled abdominal pain.
Bowel function that remains painful.
Impaction-hardened stool that does not come out.
Where can I get more information?
Call the American Cancer Society at: 1-800-ACS-2345 or visit on the internet at: http://www.cancer.org.
Call the National Cancer Institute at: 1-800-4-CANCER or visit on the internet at: http://www.cancer.gov/cancerinfo/. Click on Coping with Cancer. Find and click on Gastrointestinal Complications.
Visit the National Institutes for Health on the internet at: http://www.nlm.nih.gov/medlineplus. Click on Constipation.
Visit the Family Care Research Program on the internet at: http://www.cancercare.msu.edu.
Visit the National Coalition for Cancer Survivorship on the internet at: http://www.canceradvocacy.org. Click on Essential Care
References:
Campbell, T., Draper, S., Reid, J. & Robinson, L. (2001). The management of constipation in people with advanced cancer. International Journal of Palliative Nursing, 7(3), 110-9.
Management of Constipation in Older Adults. Best Practice: Evidenced Based Practice Information Sheets for Health Professionals (1999). 3(1), 1-4.
Massey, R.L., Haylock, P.J., & Curtiss, C. (2003). Constipation. In C.H. Yarbro, M.H. Frogge, & M. Goodman (Eds.), Cancer symptom management, 3rd Ed. (pp. 512-527). Boston: Jones and Bartlett.
