Constipation Is a Real Pain for Oncology Patients

Submitted by Megan Barkhurst, NP on June 07, 2021

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Are medications giving you unintended side effects?

You’re working hard to get well and feel better, but the very medications designed to help you can also have some frustrating side effects. 
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Nobody likes to talk about their bathroom habits, but constipation is truly a very normal concern for patients undergoing cancer treatment. Many oncology patients are prescribed opioids for pain management. Unfortunately, constipation can occur in up to 90 percent of patients taking them. The reason this occurs is because opioids bind to receptors in the gastrointestinal tract, as well as the central nervous system, which can slow down the digestive system.
 

How do you know if you are constipated?

Symptoms of constipation include:
  • Straining to produce a bowel movement
  • Lumpy or hard stools
  • Fewer than three spontaneous bowel movements per week
  • Sensation of incomplete evacuation or obstruction
Most patients will also have associated and uncomfortable symptoms such as nausea, bloating, abdominal and/or back pain and lack of appetite.
 

Constipation doesn’t have to be a constant. 

Before beginning any regimen to combat constipation, it is important to be open and honest with your oncologist or palliative care team about what you are experiencing, as the constipation could be disease-related, rather than medication-related. He or she may also be able to provide you with prescription medications to help. However, the following suggestions may enable you to find relief at home:
  • Be sure to drink plenty of fluids
  • Prioritize exercise, even if only walking daily
  • Make fruits and vegetables the largest part of your diet
  • Take an over-the-counter fiber supplement
Contact your doctor if any of the following symptoms occur in addition to your constipation, as they could signal an ongoing problem.
  • Belly pain
  • Blood in your stool
  • Worsening constipation and/or changes in the look of your stool
  • Fever
  • Stool leakage
Toileting concerns can feel embarrassing to talk about, but I can assure you that they are regular topics for the members of your medical team. Be sure to ask for help so you can prioritize your wellness.
 
Megan Barkhurst is a Nurse Practitioner at Chesapeake Regional’s Priority Toyota Cancer Center. She partners closely with various oncology specialists to provide outpatient palliative care to the region’s oncology patients. After receiving her Master of Science degree from the University of Tampa, in Tampa, Fla. she chose to follow her life’s passion into the field of palliative care. She works closely with cancer patients and their family members to assist patients with symptom management, goal guidance and transition of care.