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Constipation is a common side effect that happens when people are taking certain pain medications or undergoing chemotherapy treatment. A factor that contributes to this element is if you are less active and perhaps do not eat as well as you regularly would. It’s critical to drink an adequate amount of fluids as well as to take in a high-fiber diet including nuts, vegetables, fruits, breads, and cereals. To avoid constipation, you should also do your best to avoid foods known to cause constipation including cheese. You should also forget conventional remedies including prune juice.
If possible, you should remember to go outside to exercise and take a walk. You might additionally need to take stool softeners and/or laxatives daily, particularly if you are also taking certain pain medications. Make sure to take these medications as recommended rather than only when you feel you need them. In some situations, if remedies are not effective, you might end up needing a suppository or enema.
Let your medical provider know if you have not had a bowel movement in several days and check with your medical provider before taking any of the recommended remedies for constipation.
What Constipation Feels Like
Many people describe constipation as one of the most painful and uncomfortable sensations they can endure. Constipation makes bowel movements painful as well as difficult. A person must strain to pass a bowel movement if he or she is constipated. Many people report the need to still defecate even after passing tools. A person can experience cramps as well as stomachs while constipated. Some people with constipation also experience leakage of soft stool resembling diarrhea.
What Represents a Healthy Number of Bowel Movements
Anywhere from 3 times a day to 3 times a week is viewed as a healthy number of bowel movements. It is not critical to have bowel movements each day. Medical professionals view constipation as not having bowel movements for three days in a row.
The Cause of Constipation
People often become constipated because there is not enough fluid in that individual’s digestive system or not enough movement in the individual’s intestine where stool is created and pushed through to be extinguished from the body. Some individuals with serious illnesses like cancer have an elevated chance of constipation if they have a tumor somewhere in their body that blocks feces from moving peacefully through the body. Additionally, changes in appetite or inadequate fluid intake can add to constipation. Additionally, people who take opioids and other types of medications are at elevated risk of constipation.
How Chemotherapy Results in Constipation
Several factors come into play regarding chemotherapy and constipation. Sometimes, chemotherapy can result in changes to the intestinal linings which result in constipation. Changes to a person’s eating habits or activity level can also trigger bowel irregularity. You might be consuming medications to address other side effects during chemotherapy that can also lead to constipation.
Medical professionals suggest that the prevalence of chemotherapy-caused constipation is around 16% in individuals with cancer. These researchers have also commented that 5% of these individuals have serious constipation while 11% have moderate constipation. The reason why chemotherapy causes constipation is not clear. Medical professionals suggest that constipation happens due to various factors connected to chemotherapy including inflammation of the intestinal tract, bowel secretion disorders, and changes to how the digestive tract interacts with the nervous system.
The Early Signs of Constipation
The beginning of constipation about which you should be watchful include:
- Small and hard bowel movements referred to as pellets
- Leaking soft stool that resembles diarrhea
- Cramps or stomach pains
- Passing a great deal of gas
- Burping frequently
- A belly that looks puffy
- Not having a bowel movement in the last three days
How Patients Can Act
If you have constipation, there are some critical steps that you should remember to take to better respond to how you respond to the illness. These steps include:
- Avoid using either enemas or suppositories.
- Digest more fluids.
- Do not chew gum or use straws to drink because these can cause gas.
- Exercise as much as possible.
- Eat at the same time daily. You should also attempt to move your bowels at the same time each day.
- Go to the bathroom as soon as you feel an urge.
- If you are given a prescription medication, cautiously follow the directions.
- If your medical team approves, digest more high-fiber foods daily including whole-grain bread, fruits, vegetables, juices, and nuts.
- Limit any food known to cause constipation including cheese.
- Log your bowel movements so you can more promptly notice potential problems.
- Request that your medical team help you arrange a daily care plan for your bowel system. Your team might recommend over-the-counter products including fiber supplements.
- Stay away from any foods or liquids that cause gas until constipation has passed.
Constipation and Nutritional Management
Constipation is a common side effect of anti-cancer as well as pain medications. Consuming adequate amounts of fluid and receiving some type of daily exercise can help to avoid constipation.
Foods that are high in fiber can ease constipation, but should not be digested by people with cancer. The medical team suggests various methods to address constipation and often prescribed laxatives or stool softeners if required.
Some medications used to treat cancer can cause constipation. Waste that remains too long in the bowels so water is absorbed from the tools will result in constipation. Some of the steps that a person can use to reduce constipation related to food include consuming plenty of liquid, consuming hot drinks like tea, and avoiding foods known to cause gas.
If you have not experienced a bowel movement for one or two days, you should contact your medical team to see if they can recommend medication. High-fiber foods help constipation, but you should check with your medical team before consuming these foods because there are some types of cancer for which high-fiber diets are not ideal.
Some of the high-fiber foods that you might consume to fight constipation include dried fruits, bran, wheat germ, fresh fruits, oats, vegetables, and barley.
How Your Medical Team Can Help You With Constipation
Your medical team can help you in various ways if you are facing constipation. Some of the helpful steps that your medical team can take if you have constipation include:
- Additional fluid that helps make bowels move
- Encourage patients to stay active, even in small ways
- Keeping a record of bowel movements
Reasons the Patient Should Contact the Care Team
A patient should contact the care team in emergencies including if the patient has not:
- Develops stools that are loose or watery
- Experiences pain in the belly or vomiting that does not stop
- Had a bowel movement in the last few days
- Has not moved bowels in 1 or 2 days after taking a softener
- Notices blood either around the anal area or blood in the stool
Common Types of Over-the-Counter Laxatives
Some of the most common types of over-the-counter laxatives used by patients include:
- Osmotic laxatives. Polyethylene glycol uses water in a person’s body to soften the individual’s stool and ease it through the colon so a person does not have a bowel movement. Side effects are not common from osmotic laxatives, but the medication sometimes causes nausea or the sensation that a person is going to throw up as well as gas and bloating.
- Stool softeners. Including medications like docusate sodium, stool softeners increase the amount of water found in a person’s stool, which make stool easier and softer to pass. These medications are known to result in few side effects. Patients take stool softener as requested by healthcare providers. Patients should avoid taking stool softeners in combination with mineral oil.
- Stimulant laxatives. Senna is a type of medication that makes sure a person has bowel movements by speeding up that individual’s muscle movements in the individual’s colon. Stimulant laxatives can cause cramping. Stimulant laxatives should preferably be taken before a person goes to bed.
- Bulk-forming laxatives. These laxatives including brand names like Fiberall, Metamucil, and Perdiem result in a more liquid-like stool that is softer and easier to pass. Some other types of bulk-forming laxatives include methylcellulose and polycarbophil. A person should take this medication with 8 ounces of liquid including water. Bulk-forming laxatives are known to result in both bloating and gas. You should make sure to speak with your medical provider before using any type of bulk-forming laxative if you are unable to get out of bed, are only allowed to consume a small amount of liquid each day, or are constipated due to pain medication.
- Enemas and suppositories. People should avoid using suppositories or medication that is placed through an individual’s anus unless a medical team tells the individual to do so. A person should not use enemas unless you’re told to do so by a healthcare provider. Enemas are a type of liquid that is placed into the rectum through the anus to lead a person to have a bowel movement.
You should follow the instructions on the label or given by a healthcare provider when taking any of these medications. If medications do not help, you should speak with your medical provider. Your provider can change the medication as well as do other things like recommend medication or suggest alternative medications.
The Role of Digital Disimpaction
Digital disimpaction involves using the fingers to physically remove stool from a person’s rectum. This can be done with an individual experiencing constipation or by a medical professional who assists in fecal impact or similar conditions that prevent a person from properly defecting.
During the procedure, one finger of a gloved hand is properly lubricated and then placed into the rectum. The stool is softly broken up and then removed in pieces until a person’s rectum is cleared. While digital disimpaction can be done alone, it also can be performed in combination with rectal irrigation.
Digital disimpaction is not suggested for constipation unless a person’s condition cannot be relieved through other methods or an individual has a medical condition that substantially disrupts bowel movements.
Some of the most common reasons why digital disimpaction might need to be performed include:
- Fecal impaction is a solid stool “stuck” in the rectum, often due to chronic constipation. Besides pain and bloating, fecal impaction can lead to the overflow of diarrhea as fluids collect behind the blockage. If not properly treated, fecal impaction can result in bleeding as well as ulcers. Some of the most common reasons why people experience fecal impaction include not consuming enough fiber, opioid drug use, foreign object obstruction, pregnancy, celiac disease, inflammatory bowel disease, and holding in bowel movements. Each of these conditions can result in substantial constipation by altering the consistency of stools or normal intestinal contraction.
- Dyssynergic defecation is a chronic condition experienced by people that is likely to require digital evacuation. The condition happens when the nerves and muscles of the pelvis do not work together smoothly in a way that create a normal bowel movement. The organs in this condition creates bowel movements that are best thought of as “out of sync”. Sometimes referred to as anismus, the condition is viewed as a type of pelvic floor disorder. Because defecation requires the voluntary contraction of the sphincter, the condition often results from the inability to voluntarily control the muscles. Some causes of the disorder include Parkin’s disease, rectal prolapse, anal canal malformation, and rectal ulcers.
- Spinal cord injuries. Some people with spinal cord injuries require digital disimpaction due to part of their daily bowel habits. Manual disimpaction is viewed as a standard type of care for people with serious injuries. Motor vehicle crashes and substantial falls are the most common reason why people experience spinal cord injuries. This condition can also result from degenerative spinal conditions or tumors on the spine. The loss of bowel functions can be either short-last or permanent. Because individuals with spinal cord injuries often experience a loss of sensation around both the anus and rectum, digital disimpaction should be conducted by a medical professional so the injury does not occur.
It is not a good idea to use digital discompaction routinely because a person is at risk of injury including both fissures of the anus and perforated rectums in addition to infection and hemorrhoids. This condition can also result in the worsening of your condition if your anal sphincter is damaged. In rare situations, fatal irregular heartbeats can occur from the act.
Your medical team can assess to determine why your bowel movements are not normal. Your team will want to locate the underlying cause and decide whether it’s a structural disorder, a disease, or an obstruction and what solutions exist.
Myths (and Realities) About Constipation
In conclusion, various myths exist about constipation. It’s important to understand the truth behind these various myths.
- Myth # 1 – A Person should have daily bowel movements. No two people are the same. While some people have three bowel movements a day, other people have three bowel movements a week. It’s common to experience bowel movements once a day, but it’s possible to go several days without one provided you feel fine. If you have less than three bowel movements a week, you are constipated. It’s severe if you have less than one bowel movement a week.
- Myth # 2 – Constipation creates toxins. Some people falsely think that constipation results in the body absorbing poisonous substances in stools resulting in diseases like asthma and even cancer. No evidence exists that stools create toxins or that colon cleansing can result in cancer or other diseases. Constipation is also not viewed as a disease.
- Myth # 3 – Constipation means you need more fiber. Many people have less fiber than their body requires, which is why it’s often a good idea to increase the amounts of fruits, grains, and vegetables that you eat. You should add fiber gradually, which ensures that your body gets used to it. Other reasons exist, however, why you might be constipated including medications.
- Myth # 4 – Swallowed gum can become stuck. While this is true, it only happens in rare cases. Sometimes consuming large amounts of gum or some gum in a short period can create substantial blocks that end up in the digestive tract. This block can result in constipation. In most cases, however, gum moves through and out of the body in the same way that other food does.
- Myth # 5 – Travel can’t cause constipation. Travel has been shown to change a person’s daily routine and diet. While a person is away, the individual should make sure to drink an adequate amount of water. If you cannot drink the water at your destination, you should make sure to also stay active. Walk while you wait for your flight, for example. You should also make sure to limit alcohol while on vacation and to continue eating healthy foods like fruits and vegetables.