Constipation is a common and uncomfortable side effect of chemotherapy, impacting daily life. Various strategies can help manage and alleviate it. This article explores practical approaches to finding relief and maintaining digestive comfort during cancer treatment.
Understanding Chemotherapy Related Constipation
Chemotherapy can lead to constipation through several mechanisms. Some chemotherapy drugs directly affect the digestive system or the nerves that control bowel function, slowing down gut motility. Additionally, anti-nausea medications, frequently prescribed during chemotherapy to manage side effects, can also contribute to reduced bowel movement.
Beyond the direct impact of medications, other factors related to cancer treatment can worsen constipation. Reduced physical activity due to fatigue or weakness can slow down the digestive process. Changes in diet, including decreased food and fluid intake, also play a role in making stools harder and more difficult to pass.
Lifestyle and Dietary Strategies
Maintaining adequate hydration is a key step in managing constipation. Drinking plenty of fluids, such as water, clear broths, and diluted juices, helps soften stools and ease passage. Aiming for at least eight to ten cups of non-caffeinated fluids daily can support this process.
Incorporating dietary fiber can also promote regular bowel movements, though this should be done gradually to avoid discomfort. Fruits, vegetables, and whole grains are good sources of fiber. However, it is important to consult a healthcare provider before significantly increasing fiber intake, as too much fiber might not be helpful for everyone, particularly if there are concerns about bowel obstruction.
Gentle physical activity, such as walking, can stimulate the digestive system and encourage bowel movements. Even short, regular walks are beneficial, depending on what is tolerable during treatment. Establishing a consistent routine for bowel movements, by attempting to have one at the same time daily, can also help train the bowels.
Be mindful of certain foods that might worsen constipation. Highly processed foods or those low in fiber contribute to constipation. Limiting or avoiding caffeine and alcohol is recommended, as these can lead to dehydration and further harden stools.
Medication Options for Relief
Medications are often necessary to manage chemotherapy-induced constipation, and these options range from over-the-counter (OTC) products to prescription drugs. Always discuss medication use with a healthcare professional before starting.
Stool softeners, such as docusate sodium, work by increasing the amount of water in the stool, making it softer and easier to pass. These are well-tolerated and are a good initial option. Bulk-forming laxatives, like psyllium, absorb water in the intestines to create a larger, softer stool, which helps stimulate bowel movements. Adequate fluid intake is essential when using bulk-forming laxatives to prevent them from worsening constipation.
Osmotic laxatives, including polyethylene glycol (PEG) and milk of magnesia, draw water into the bowel from other parts of the body, helping to soften the stool and promote movement. These can be effective within 24 to 72 hours. Stimulant laxatives, such as senna or bisacodyl, directly act on the nerves in the intestine to stimulate contractions that push stool along. While effective, long-term use of stimulant laxatives without medical supervision is not recommended.
For persistent or severe constipation that does not respond to OTC options, healthcare providers may prescribe stronger medications. These might include drugs like lubiprostone or linaclotide, which work through different mechanisms to increase fluid secretion in the intestines and improve bowel function. Medication selection depends on individual circumstances and the specific cause.
Knowing When to Contact Your Healthcare Team
Communicate with your healthcare team about any changes in bowel habits during chemotherapy. Persistent constipation that does not improve with home remedies or over-the-counter medications after a few days warrants medical attention. While the specific timeframe varies, not having a bowel movement for two to three days should prompt a call to your care team.
Severe symptoms accompanying constipation, such as intense abdominal pain, significant bloating, nausea, or vomiting, require evaluation. They could indicate a serious issue, like a bowel obstruction. Any new or worsening symptoms, or a significant deviation from your usual bowel habits, should also be reported.
Rectal bleeding or severe rectal pain should be reported immediately to your healthcare provider. Inability to pass gas with constipation, or severe abdominal distension, also necessitates urgent medical consultation. Always follow your cancer care team’s specific instructions on when to seek help for constipation.