Cancer and Constipation

Constipation is a common side effect of cancer treatment that can be caused by certain chemotherapies, nausea and pain medications, changes in diet, or a decrease in physical activity level.

What causes constipation?

The inability to move one’s bowels, having bowel movements less often than is normal, or having to push more than normal to move your bowels can all cause constipation. Constipation occurs when your stool becomes hard, dry and difficult to pass. This causes bowel movements to be less frequent, painful and often accompanied by cramps, gas, bleeding or feelings of bloating and nausea.

It is important to prevent and treat constipation early as it can lead to hemorrhoids and impaction, which is when the stool is compacted and unable to pass. Contact your medical team if you have not had a bowel movement in 2-3 days or if you are having unusual pain or discomfort, or bleeding from your rectum.

Tips for Managing Constipation

  • Be sure to stay hydrated. Drink a minimum of 8-10 8 oz. glasses of fluid per day
  • Consume warm liquids, which may help to stimulate a bowel movement
  • Consume foods rich in dietary fiber such as bran, whole grain breads, rice, cereal and pastas, as well as fresh fruits and vegetables, beans and nuts.
  • If bowel gas is a concern, limit gas-producing foods such as carbonated beverages, broccoli, cauliflower, cabbage, peas, beans, onions, and raw peppers. Also limit swallowing air from drinking through a straw or chewing gum.
  • Stay active. A short walk may help treat and prevent constipation.
  • Speak to your physician if you find that dietary management does not help to improve bowel movements, as you may need medication to help promote regularity.
  • Always communicate with your doctor or nurse about what you are experiencing.

Diet plays an important role in the prevention and management of constipation. Insoluble fiber, a certain type of dietary fiber, is not digested by the body and can help to prevent constipation. Insoluble fiber is found in the outer skins and fibers of fruits, vegetables, and grains. It can add bulk and weight to the stool and helps to promote regularity.

It is important to always consume dietary fiber with adequate fluids in order to allow the fiber to work appropriately and prevent worsening constipation.

Tips for Adding Fiber to Your Diet

  • Choose whole wheat and whole grain breads, rice, cereals, and pastas.
  • Include a minimum of 5 servings of fruits and vegetables in your diet each day.
  • Snack on fresh fruit, dried fruits, a palm full of plain unroasted nuts, or raw veggies instead of unhealthy alternatives.
  • Add dried fruits or chopped nuts to cereals, yogurts, and salads.
  • Add extra vegetables to your meal in stir fries, pastas, casseroles, soups, and salads.

If your constipation is associated with intestinal blockage or bowel obstruction, be sure to speak with your physician and healthcare team before making any dietary changes, as certain types of fiber may worsen your condition.


References

Eldrigde B, Hamilton K. “Constipation Management” Patient Education Handout. Management of Nutrition Impact Symptoms in Cancer and Educational Handouts. Oncology Nutrition Dietetic Practice Group of the Academy of Nutrition and Dietetics.

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