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Tuesday, 1 October 2013

Caring For The Patient With Cancer At Home (Symptom- Constipation)

Constipation is one of the symptoms a patient with cancer can have. It is defined as the infrequent or difficult passage of hard feces (stools), which often causes pain and discomfort.

It could be caused due to any of the following reasons :
  • poor food and fluid intake
  • not enough movement in the bowel
  • lack of activity
  • weakness
  • ignoring the urge to have a bowel movement
  • intake of certain medicines

What To Look For :
  • small, hard bowel movements
  • leakage of soft stool that looks like diarrhea
  • stomach ache or cramps
  • passing a lot of gas or frequent belching
  • belly appears blown up or puffy.
  • no regular bowel movement within the past three days.
  • vomiting or nausea.
  • feeling of fullness or discomfort.

What The Patient Can Do :
  • Drink more fluids. Fresh fruit juices and warm or hot fluids in the morning are especially helpful. 
  • Increase the amount of fiber in the daily diet by eating foods like whole grain breads and cereals, fresh raw fruits with skins and seeds, fresh raw vegetables, fruit juices, dates, apricots, raisins, prunes, prune juice and nuts.

  • Avoid foods and drinks that cause gas such as cabbage, cauliflower, broccoli and carbonated drinks.

  • Try to avoid any foods that cause you to be constipated such as cheese, eggs, products made of refined flour such as white bread, biscuits, naans, roomali roti etc

  • Get as much light exercise as you can.

  • Do not use enemas or suppositories. Use stool softeners or laxatives only after talking with your doctor or nurse.

  • Go to the bathroom as soon as you have the urge to have a bowel movement.
  • Keep a record of your bowel movements so that problems can be noticed quickly.

What Caregivers Can Do :
  • Offer the patient prune juice, hot lemon water, or tea to help stimulate bowel movements.

  • Encourage the patient to drink extra fluids.

  • Help keep a record of the patient's bowel movements.
  • Offer high fiber foods such as whole grains breads and cereals, dried and fresh fruits, vegetables, and bran.

  • Consult the doctor before giving the patient laxatives.

Call the doctor if the patient :
  • Has not had a bowel movement in 48 hours.
  • Has blood in or around anal area or in stool.
  • Cannot move bowels within one or two days after taking a laxative.
  • Has cramps or vomiting that won't stop.

Reference: Caring for the Patient with Cancer at Home - a Guide for Patients and Families