Cancer Center New Mexico

Many cancer therapies can cause constipation.

Constipation and Cancer Patients:

There are many reasons why a cancer patient may have constipation, such as: • Some medications, such as pain medications, certain anti-emetics and some types of chemotherapy, can cause constipation. The constipation from narcotic pain relievers occurs in most patients, and should be prevented in advance. Reduced activity and poor eating habits, often caused by the cancer and its treatment, can also cause constipation. Reduced intake of fluids and high fibre foods, along with general weakness and fatigue, reduce the body’s ability to keep regular bowel movements. Blockage of the bowels by tumours or invasion of the bowels by cancer cells.

Some of the signs of constipation

  • No regular bowel movement for 3 or more days.
  • Small, hard stools (bowel movements).
  • Leakage of stools, resembling diarrhea.
  • Stomach ache or cramps, bloated abdomen (belly), feeling of fullness or discomfort.
  • Passing excess gas or belching.
  • Nausea or vomiting.

What should you do if you notice any of these symptoms:

If you have not had a bowel movement for 3 or more days (or 2 days, if you are using regular laxatives), you should call your doctor or nurse. You may need some medication to help you start having regular bowel movements again. You should call your doctor if you have any of the following symptoms:

  • Blood in the anal canal or stools
  • Abdominal cramps or pain for 2 or more days

If still constipated, contact your physician, primary nurse or pharmacist.

Only after consultation should the following laxatives be used to relieve your constipation and they should be used on an ‘as needed’ basis only:

  • Glycerin Suppository starts working in 15 minutes to 1 hour.
  • Bisacodyl Suppository starts working in 15 minutes to 1 hour.
  • Fleet® Enema starts working almost instantaneously.
  • If still constipated: add ACILAC® (lactulose) 15 mL (1 tablespoon) two to four times daily.
  • If still constipated: increase Senokot® to maximum daily dose of 8 tablets a day AND take MILK OF MAGNESIA (MOM)* 30 to 60 mL at bedtime. OR Change Senokot® to stimulant laxative DULCOLAX® (bisacodyl) 5mg tablet: 1 to 3 tablets a day. *Consult with your pharmacist or physician if you have heart or kidney problems before taking this medication. Try stimulant laxative, SENOKOT® (senna): 1 to 4 tablets twice daily (in the morning

Constipation information prepared by the Toronto Sunnybrook Regional Cancer Centre Pharmacy. Revised by the Cancer Care Ontario-Professional Pharmacy Advisory Committee- Medication Information Sheets Working Group.