Gastrointestinal Complications (PDQ®): Supportive care - Patient Information [NCI] - Constipation
For patients who have colostomies, care of the colostomy will be discussed.
Treating constipation is important to make the patient comfortable and to prevent more serious problems.
It's easier to prevent constipation than to relieve it. The health care team will work with the patient to prevent constipation. Patients who take opioids may need to start taking laxatives right away to prevent constipation.
Constipation can be very uncomfortable and cause distress. If left untreated, constipation may lead to fecal impaction. This is a serious condition in which stool will not pass out of the colon or rectum. It's important to treat constipation to prevent fecal impaction.
Prevention and treatment are not the same for every patient. Do the following to prevent and treat constipation:
- Keep a record of all bowel movements.
- Drink eight 8-ounce glasses of fluid each day. Patients who have certain conditions, such as kidney or heart disease, may need to drink less.
- Get regular exercise. Patients who cannot walk may do abdominal exercises in bed or move from the bed to a chair.
- Increase the amount of fiber in the diet by eating more of the following:
It's important to drink more fluids when eating more high-fiber foods, to avoid making constipation worse. (See the Constipation section of the PDQ summary on Nutrition in Cancer Care for more information.) Patients who have had a small or large intestinal obstruction or have had intestinal surgery (for example, a colostomy) should not eat a high-fiber diet.
- Fruits, such as raisins, prunes, peaches, and apples.
- Vegetables, such as squash, broccoli, carrots, and celery.
- Whole grain cereals, whole grain breads, and bran.
- Drink a warm or hot drink about one half-hour before the usual time for a bowel movement.
- Find privacy and quiet when it is time for a bowel movement.
- Use the toilet or a bedside commode instead of a bedpan.
- Take only medicines that are prescribed by the doctor. Medicines for constipation may include bulking agents, laxatives, stool softeners, and drugs that cause the intestine to empty.
- Use suppositories or enemas only if ordered by the doctor. In some cancer patients, these treatments may lead to bleeding, infection, or other harmful side effects.
When constipation is caused by opioids, treatment may be drugs that stop the effects of the opioids or other medicines, stool softeners, enemas, and/or manual removal of stool.