Understanding the Problem

Constipation -- infrequent, small, hard bowel movements -- is a common problem. Some of the reasons why constipation occurs are decreased activity level, decreased food and liquid intake, and use of narcotic pain medicines.

Normally, the small bowel absorbs nutrients from food as it is digested. The liquid stool then passes into the large bowel where fluids are absorbed to maintain the body's fluid balance.

The movement of food through the system is slowed down by decreased eating and drinking, decreased activity, and pain-relieving drugs, especially narcotics. This allows more water to be absorbed out of the stool and results in hard stool that is more difficult to pass out of the body.

Call your health care provider right away if you have any of the following:

• Your bowel pattern becomes abnormal for you
• You develop cramping, abdominal pain or excessive gas
• You have tried diet and activity changes and your symptoms of constipation are not relieved in one day
• You have loose stool, but still feel like you need to have a bowel movement
• You become weak or feel faint
• The laxatives recommended by your health care team are not effective

Activities to Prevent or Decrease Constipation

• Drink more liquids. Six to eight glasses of water, juice, tea, or your preferred liquid daily
• Exercise is very important. Walk around in your home or outside three times per day for at least 15 minutes, if you are able
• Your diet should include as much fiber as you can tolerate without excessive gas. Fiber is found in whole grain bread or cereal, beans, raw or cooked vegetables, and fruit. Prune and prune juice naturally stimulate the bowel
• You may also try consuming several spoonfuls of the following mixture one to two times a day. Keep it in the refrigerator after mixing the ingredients
  • 1 cup of prune juice
  • 1½ cups applesauce
  • ½ cup bran

Medications to Prevent or Decrease Constipation

Check with your health care provider before taking any laxatives, suppositories or enemas. If your blood counts are low, you should not use suppositories or enemas.

This article is intended as a resource for patients receiving their cancer care at Duke University Hospital or Duke Clinic. It is not intended to substitute for medical advice from your health care team. If your doctor’s instructions differ from the information in this article, please talk with your doctor before making any changes.

11/05