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Preventing constipation

while undergoing chemotherapy

and using anti-nauseants

Constipation

Constipation is defined as the state in which an individual experiences a change in normal bowel habits characterized by a decrease in frequency and/or passage of hard, dry stools. Constipation can lead to bloating and discomfort and can sometimes be painful. This can lead to a reduced quality of life.

Other symptoms may be:

Incomplete bowel movement

Abdominal pain

Recommendations:

Drink approximately 2 liters of fluid per day. All fluids count. Try to vary your intake with different types of juice, smoothies, tea and bouillon. It is best to drink temperate/lukewarm fluids.

Extra fluids do not relieve constipation, but a decrease in fluids can lead to dehydration, which leads to an increased risk of constipation.

Physical activity helps prevent constipation and leads to a natural increase in one’s appetite. An increase in activity can improve bowel function for those that sit or lie in bed often.

Eat meals on a regular basis. Breakfast is especially important in order to stimulate the bowels.

Eat high-fiber foods such as:

Whole grain breads, cereals and seeds

Vegetables: raw, cooked or pureed

Fruit (preferably with the skin) and fruit bread, nuts and berries

Figs, raisins and apricots

5-10 prunes soaked in water daily, prune puree, prune juice

Fiber supplements in the form of tablets and granules. Fiber binds fluid in the bowels and softens the contents. It is important that you drink an adequate amount of fluids. Otherwise, the fiber can worsen constipation.

Flaxseed contains approximately 30 % fiber, both soluble and insoluble fiber. The insoluble fibers lead to an increase in volume and the soluble fibers create a gel like mass, bind water and can soften the stool. Whole flaxseed is recommended rather than ground seed.

Provide a comfortable, quiet, private environment for defecating. Go to the bathroom as soon as you feel the need to defecate. If you go to the bathroom at set times it might be helpful to drink something warm 30 minutes in advance.

Maintain a diary of bowel movements.

Don’t wait more than 3 days without having a bowel movement before you contact a doctor or nurse.

Laxatives for preventing and relieving constipation:

Natriumpicosulfate (Laxoberal®) is an effective laxative. It has no taste and can be mixed with different types of food or drink. Talk to your doctor about how to use this laxative.

Lactulose (Duphalac, Laktulose, Levolac), in fluid form, can be mixed in any type of drink and is recommended as a treatment for acute constipation in adults over 18 years of age with no known gastrointestinal illness. Do note that Laktulose can give a feeling of being bloated, abdominal pain and gas.

Polyethylene glycol (Laxabon, Movicol, Endofalk) can be recommended. Talk to your pharmacist about how to use this product.

Psyllium (Lunelax og Visiblin) can help. To benefit from these you must have good functional status, be physically active and have an adequate fluid intake. It is recommended to take psyllium with a minimum of 2-3 deciliters of water.

If your stool is very hard, difficult to pass and impacted, it may be necessary to have an enema to aid in normalizing the bowel.

There are many types of laxatives available. As soon as you notice changes in your normal bowel movement patterns, consult with your doctor or nurse. It is important that you, along with your doctor or nurse, find out what works best for you in order to prevent constipation.

Telephone number to the Oncology Department:

5597 2010

Approved by:

Olav Mella, Director, Dept. of Oncology and Medical Physics

Date: May 2020

Text translation:
Paula Mjelde, Oncology nurse