Constipation - ASCO curriculum

Symptoms

People with constipation may experience the following symptoms:

Pain
Swelling in the abdomen
Appetite loss
Nausea and vomiting
Inability to urinate
Confusion

Causes

Constipation can result when the body begins absorbing more water or begins signaling food to move through the bowel system more slowly. The following cancer-related factors and cancer treatments might also cause constipation:

Medications, including antacids; some drugs to treat nausea and vomiting, seizures, depression, diarrhea, or blood pressure; iron supplements; some chemotherapy drugs; and pain medications
Eating less food
Bowel obstruction
Dehydration
Immobility (lack of movement)
Tumor compression (cancer pressing on the spinal cord)
High levels of calcium in the blood
Low potassium levels
Thyroid problems
Diabetes

Diagnosis

In planning treatment for constipation, the doctor may do a rectal examination to make sure you don't have a tumor obstructing your rectum and to determine whether there is hard stool in your rectum. The doctor may also ask you about the following:

Your bowel habits, before the cancer and now
Use of medications that may cause constipation
Recent food and fluid intake
Other diseases or illnesses

Treatment

It is very important to treat constipation properly. If it is left untreated, constipation can cause internal damage to the intestine or rectum, dehydration, or bowel obstruction. It can also slow the body's absorption of medications taken by mouth. The following suggestions can help control constipation:

Drink more fluids.
Take laxatives, given either by mouth or through the rectum.
Change the dose or stop medications that cause constipation (under the supervision of your doctor).
Eat more fiber or take psyllium or methylcellulose to add fiber to your diet.
Increase physical activity, if possible.
Have an enema or rectal suppository.

Last Updated: August 11, 2005