Constipation is a common symptom in people with cancer and during cancer treatment. Constipation means that you are not opening your bowels as regularly as normal, and it can become difficult or painful for you to pass a bowel motion.
Some chemotherapy drugs, anti-sickness medications and painkillers can cause constipation. Changes to your regular routine, normal dietary intake, increased levels of stress and possibly being less active than normal, can all play a part.
It is a common misconception that if you are eating less than normal, and don't feel the need or the urge to open your bowels, that there is no need to intervene. On the contrary, severe constipation can lead to problems such as overflow diarrhoea, headaches, nausea and loss of appetite, and if left, more serious complications. If you haven't opened your bowels for more than 3 days it is important to speak to your Doctor or specialist nurse for advice.
If you have cancer of the bowel, or you think that your bowel may be affected by your cancer treatment, talk with your healthcare professional before considering any radical changes to your diet. Increasing the fibre in your diet may not be appropriate, and could even make your symptoms worse.
First line steps…
If you have a good appetite and are able to enjoy a varied diet, a good place to start is to evaluate your diet and lifestyle.
1. Gradually increase your daily intake of fibre: on average, most people in the UK consume about 18g of fibre a day and ideally you should be aiming towards 30g a day. Fibre is only found in food that comes from plants, such as fruit and vegetables, nuts, seeds and grains and is usually categorised into two groups. Each type of fibre helps your body in different ways, so it’s important to include both in your diet.
Soluble fibre: foods rich in this kind of fibre include oats, barley, rye, fruits like banana and apples, beans and pulses e.g. kidney beans and chickpeas, flaxseed and root vegetables such as carrot and swede.
Soluble fibre dissolves in water and forms a gel-like substance in the gut. This helps to keep your stools soft and makes them easier to pass.
Insoluble fibre: foods rich in this kind of fibre include whole grains, bran, green leafy vegetables and the skins of fruit and other vegetables.
Insoluble fibre bulks up your stool and acts like nature’s broom, sweeping through your bowel to get waste out more quickly and keep things moving.
2. Drink enough fluid: as a general rule of thumb, if you are less than 60 years old then you should be aiming to take 35mls of fluid per kilogram of your body weight. So for example, if you weigh 60 kg then your daily fluid requirement is approximately 2.1 litres per day. If you are over 60 years old, aim to take 30mls of fluid per your weight in kilograms. Great choices include water, herbal teas (drink hot or cold), vegetable juices, coconut water (containing no added sugar) and de-caffeinated drinks.
3. Regular exercise: helps to stimulate gut motility and get transit moving. If you sit, constipation gets worse. Swimming is a great exercise to help alleviate constipation. Try to be as active as you can each day.