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Information
for Patients and Caregivers
Constipation
What is constipation?
Definition
Constipation is defined as a condition in which
bowel movements are infrequent, incomplete or an
individual experiences difficulty in passing stool.
Constipation is a common problem for persons taking
opioid medications for their pain, those with infrequent
fluid intake, inadequate fiber intake, and decreased
activity levels. Constipation can also occur from
the disease itself, chemotherapy or other drug therapies.
How do people describe treatment-related constipation?
Many people have described constipation as a distention
or bloating in the abdomen, a pressure or sense
of fullness in the rectal area, small amounts of
stool “leaking”, small frequent “smears” of stool,
rectal pain with a bowel movement, and constantly
feeling the need to have a bowel movement but unable
to pass stool.
What causes treatment-related constipation?
The cause of constipation varies from person to
person. Constipation can be caused by pain medication,
chemotherapy agents such as Vinorelbine or Adriamycin,
emotional stress, fever, changes in diet, or decreases
in physical activity. Constipation is a common problem
for people experiencing weakness, who spend a lot
of time in bed, or a re not eating well.
How do people cope with treatment-related constipation?
- Drink 8-10 8oz. glasses of water or other non-caffeinated
drinks every day.
- Exercise every day. Even mild exercise, such
as walking, helps.
- Don’t use suppositories without talking to your
physician.
- Ask for a stool softener and/or laxative from
your healthcare provider.
- Eat foods high in fiber such as raw vegetables,
popcorn, raisin bran, beans, raisins and prunes.
- Establish a routine every day with privacy to
go to the bathroom.
- Drink warm liquids such as lemon water, prune
juice or tea after mealtime to stimulate bowel
activity. If this doesn't work, try using a glycerin
suppository.
- 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 when possible; caffeine causes
dehydration.
- Avoid regular use of enemas.
- Try going to the restroom after mealtime.
- Check with your doctor first, then take 1-2
stool softeners daily, and a laxative if taking
narcotics. Examples are: Colace 50mg 1-2 tablets
up to three times per day, and/or Surfak 240 mg.,
1 tablet a day.
What can family members and friends do to help
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 remind you
to exercise every day.
- Ask family members and friends to remind you
to take a stool softener or laxative as directed.
How can I talk with my family members about constipation?
- Request privacy to discuss your concerns.
- Ask your family members what he/she thinks
is causing your constipation.
- Try to describe how the constipation makes you
feel.
What should I report to my doctor or nurse?
You should contact your doctor or nurse if:
- Fever greater that 100.5 for more than 24 hrs.
- The normal routine was once a day and now there
has been no bowel movement in 3 or 4 days.
- The normal routine was every other day and
now there has been no bowel movement in 4 or 5
days.
- Severe straining on the toilet or commode.
- Severe abdominal pain or abdomen that feels
harder than normal and very full.
- Red blood around the outside of the stools
or problems with hemorrhoids. Report and pain
or bleeding.
Where can I get more information?
References
Campbell, T., Draper, S., Reid, J. & Robinson,
L. (2001) The management of constipation in people
with advanced cancer. International Journal of Palliative
Nursing, Mar; 7 (3), 110-9.
Management of Constipation in Older Adults. Best
Practice: Evidenced Based Practice Information Sheets
for Health Professionals (1999). Volume 3, (1),
1-4.
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