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Chemotherapy and Constipation

What You Can Do to Prevent and Treat Constipation During Chemotherapy

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Updated November 14, 2010

Constipation can often be a side effect of chemotherapy or other medications prescribed during treatment, such as certain pain medications and serotonin-based drugs that relieve nausea and vomiting (Aloxi and Zofran, among others). Constipation is defined as having hard or infrequent stools or difficulty in having a bowel movement.

How to Manage Constipation During Chemotherapy

The first thing you should do is to talk to your doctor. Tell him that you are experiencing constipation or hard/infrequent stools. Your doctor will likely want to know about your eating habits, if you have taken any over-the-counter laxatives, enemas, or suppositories, and confirm medications you are taking. It helps to be especially assertive when listing your medications to your doctor, since many medications used in cancer treatments and pain relief can cause constipation. These questions will help determine the exact cause of the constipation.

Note: Before taking any over-the-counter medication, talk to your doctor or nurse. For some chemotherapy patients, over-the-counter medications can be harmful.

Laxatives

Your doctor may prescribe a laxative or suppository to help with the constipation. You may want to ask how long it will take for the medication to begin working, possible side effects, and for what duration should you take the medicine.

An over-the-counter laxative also may be recommended. Be sure to follow the doctor's instructions of how often you should take the medication.

Increase Fiber in Your Diet

For mild cases of constipation, increasing fiber in the diet can be all the body needs to have regular bowel movements. Before increasing fiber in the diet, ask your physician. Some patients should not have increased fiber, such as those who have had a bowel obstruction or bowel surgery.

Increasing the amount of fiber starts with the foods you eat. Nuts, bran, vegetables, legumes, whole wheat breads and pastas, and fruits are all high-fiber foods that can help relieve constipation.

Talk to your doctor about how much fiber you should be getting daily. The suggested dietary intake for healthy women is 21-25 grams and men should consume 30-38 grams per day. You can find out how much fiber is in a certain food by reading the label on the packaging.

Exercise

Exercise is still very important when going through treatment. Something as simple as going for a short, regular walk can help to prevent and relieve constipation. For those who are bed ridden, moving from a chair to the bed can help because it utilizes the abdominal muscles.

Before starting any exercise, no matter how little you think it may be, talk to your doctor. He or she can recommend exercises and tell you just how much you should be getting.

Fluid Intake

Many patients report some relief when increasing the amount of fluids they intake. Drinks like water and juices are recommended. Avoid drinks that contain caffeine, like sodas, coffee, and alcohol, because they can cause dehydration, which could worsen constipation.

The Seriousness of Constipation

Chronic severe constipation can lead to fecal impaction, a condition in which hard, dry fecal matter that develops in the rectum and cannot be passed. The impacted feces are then removed by the doctor manually.

Other complications from chronic constipation include hemmorroids, anal fissures, and rectal prolapse.

References:

"Constipation." Digestive Diseases. Feb 2006. National Digestive Diseases Information Clearinghouse. 1 Mar 2007 <http://digestive.niddk.nih.gov/ddiseases/pubs/constipation/>.

Gastrointestinal Complications: Constipation." 19 July 2006. National Cancer Institute. 1 Mar 2007 <http://www.cancer.gov/cancertopics/pdq/supportivecare/gastrointestinalcomplications/Patient/page3>.

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