Constipation
What is constipation?
Constipation means bowel movements happen less often than usual, or the stool becomes hard, dry, or difficult to pass. Constipation does not only mean “not going often,” but can also include straining, feeling like the bowel does not empty fully, or having pain when trying to go.
What does constipation look like?
Constipation may look like fewer bowel movements, hard or lumpy stool, straining, stomach cramps, bloating, or a feeling of fullness. Some patients also feel nauseated or have a decreased appetite because stool is moving too slowly through the intestines. In very severe cases, stool can build up in the intestines and cause a blockage.
Who gets constipation?
Constipation can happen due to low fluid intake, not enough dietary fiber, decreased physical activity, changes in routine, or certain medications. In patients with cancer, constipation is common because cancer treatment can affect diet, activity, and normal bowel function. One common cause of constipation in patients with cancer is the use of opioid pain medications. Opioids slow the movement of the intestines, reduce normal gut secretions, and can make stool drier and harder.
How is constipation prevented?
Prevention usually starts with simple daily habits such as drinking enough fluids, staying as active as possible, and eating fiber when appropriate. Patients who are at high risk of constipation, such as those receiving opioid pain medications, may be started on a bowel regimen with certain laxatives to help prevent constipation. Medications that are commonly used as part of a bowel regimen include sennosides + docusate (Senna-S®) and polyethylene glycol (MiraLAX®).
How is constipation treated?
Treatment depends on the cause and how severe the constipation is. Common medication options include stimulant laxatives, osmotic laxatives, and enemas. Stool softeners help make stool easier to pass, while stimulant laxatives help the bowel contract and move stool along. Osmotic laxatives work by pulling water into the bowel to soften stool and help it move. Some examples of these medications, most of which are available over-the-counter (OTC), include:
- Stimulant laxatives
- Sennosides (Senna®)
- Bisacodyl (Dulcolax®)
- Osmotic laxatives
- Polyethylene glycol (MiraLAX®)
- Magnesium citrate
- Magnesium hydroxide
- Lactulose
- Sorbitol
- Enemas
- Sodium phosphate (Fleet®)
- Mineral oil
- Glycerin
- Tap water
For patients that have low white blood cells (neutrophils) or low platelets, it is not recommended to treat constipation with enemas.
For constipation related to opioids, if regular laxatives do not work well enough, some patients may need additional medications that are specifically used for opioid-induced constipation such as methylnaltrexone (Relistor®), naldemedine (Symproic®), or naloxegol (Movantik®).
NOTE: Treatment Options listed below are not all-inclusive. Other treatments may be available. ChemoExperts provides drug information and does not recommend any one treatment over another. Only your Doctor can choose which therapy is appropriate for you.
Treatment Options
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