Constipation

Many cancer patients experience constipation, which is the infrequent or difficult passing of hard, dry stool. The primary symptoms are a lack of a bowel movement for three or more days, hard stool, gas and/or bloating.

Constipation often causes pain and discomfort, and can be caused by a variety of factors including:

• Pain medication. Many medicines used to alleviate pain slow the gastrointestinal tract, which can cause constipation. If you are taking pain medications and experience constipation, let your care team know. You may need a stool softener or laxative to counteract the pain medication’s side effect.
• Decreased activity. Cancer treatment often causes fatigue. Physically slowing down also slows down the gastrointestinal tract.
• Decrease in consumption of food and liquid. Some cancer treatments, such as chemotherapy, cause nausea and/or vomiting, which prevents patients from eating and drinking as much as normal. That can lead to constipation. If you are experiencing a change in appetite and have constipation, tell your care team so they can help you manage both side effects in tandem.

Regardless of the cause of your constipation, some of these dietary tips could help relieve or prevent constipation:

Consume eight to 12 cups (8 ounces each) of fluids every day. Fluids include water, juice, sports drinks, milk, soups, broths and solids that become liquid at or above room temperature, such as Jell-O and ice cream. At least half the fluids you consume in a day should not contain caffeine. Getting enough liquid will keep your stool soft. If your urine is a dark shade, you are experiencing dehydration.

• Eat small, frequent meals.
• Eat high-fiber foods, such as peas, beans, seeds, whole grains (brown rice, barley, quinoa and oats), and fruits and vegetables with thick peels or skins.
• Drink warm or hot liquids (including soups) to stimulate your gastrointestinal tract.
• Eat dry cereals that have at least nine grams of fiber per serving.
• Snack on nuts or popcorn.
• Add wheat germ or bran cereal to yogurt, salads, casseroles or baked goods.

Some patients may need to take stool softeners or laxatives, or may need enemas, to relieve constipation. There are many over-the-counter options, but you should speak to your care team before using them. Your care team will make recommendations that address your specific case and give you instructions as to when and how to use medications or enemas.