Constipation Tablets

Managing Constipation: Tips for Cancer Patients

Constipation is difficulty passing stools or a decrease in number of stools. It may be accompanied by gas, abdominal cramping or pressure in the lower abdomen.

What is constipation?

What causes constipation?

Constipation is caused by a slowing of the intestinal activity. The normal wave-like action of the intestines, called peristalsis, serves to continually move stools out of the body. When peristalsis slows, the stools become hard, dry and difficult to pass.

Constipation can have a number of causes including:

• Pain medications
• Chemotherapy drugs
• Decreased activity
• Poor diet
• Inadequate fluid intake

What are the symptoms of constipation?

Some symptoms of constipation include:

• A sustained change in frequency of bowel movements from your normal. There is no "normal" schedule for bowel movements; everyone's schedule is different. If you normally move your bowels once per day, a change may be every 2nd or 3rd day.
• Hard, difficult to pass bowel movements. You may pass small, marble-like pieces of stool without a satisfactory elimination.
• Cramping and/or flatulence (gas).

How can constipation be prevented?

It is easier to prevent constipation with lifestyle changes than to treat it once it happens. Here are some tips.

• Drink plenty of water. Taking in enough fluids keeps the stool soft. Try to drink 6-8 glasses (8 oz.) of fluid a day.
• Eat foods high in fiber, such as fruit, vegetables and beans. High-fiber foods stimulate the intestines to move.
• Avoid cheese, meat, processed food and other low fiber foods that cause constipation.
• Exercise daily. Exercise helps stimulate digestion and prevent constipation. Moderate activity such as walking will help.

It may also help to keep track of your bowel movement schedule so that you can learn which lifestyle measures work best for you. If you miss a bowel movement, try increasing your fluid intake or adjusting your diet. Call your doctor if your bowels have not moved in two days.

How is constipation treated?

Relistor (methylnaltrexone bromide): For patients who develop constipation as a result of opioid pain medications (such as morphine, codeine, oxycodone, and fentanyl), Relistor provides another approach to treating constipation.[1] Relistor acts by blocking the activity of opioids in the gastrointestinal tract without blocking the pain-relieving effects of opioids in the central nervous system.

Additional information about managing side effects of treatment

Reference:

[1] Thomas J, Karver S, Austin G, et al. Methylnaltrexone for opioid-induced constipation in advanced illness. New England Journal of Medicine. 2008;358:2332-2343.