Early detection of constipation caused by cancer and treatment

The article was consulted with Specialist Doctor I Dong Xuan Ha - Gastroenterologist - Department of Medical Examination & Internal Medicine - Vinmec Ha Long International General Hospital.

Constipation is defined as defecation ≤ 3 times/week, stools are hard, or there is a feeling that the bowels are not completely empty but must use measures to stimulate defecation. Constipation due to cancer is a common symptom, especially in patients with gastrointestinal cancer. Constipation in cancer patients can have many causes. For example:
Eating unbalanced and full of nutrients, especially fiber. Under the influence of pathology and/or therapeutic intervention, cancer patients often have anorexia, poor appetite, reduced digestive system function, and decreased secretion of digestive enzymes. This will reduce the stimulation of bowel movements that cause constipation. Not drinking enough water causes the body to increase water absorption from the intestines to compensate. Dehydrated stools will be harder and tighter. Cancer patients often feel tired and weak, thus limiting physical activity. This reduces bowel movements, and food moves through the intestines more slowly than usual, leading to constipation. Constipation in cancer patients can be caused by a side effect of some medications such as: pain relievers (reducing bowel movements, causing food to move slowly through the digestive tract); medicines for nausea and vomiting, anticonvulsants, antidepressants, antidiarrheals, antihypertensives, and iron supplements. Chemotherapy and radiation therapy in cancer patients also cause constipation as a side effect. Gastrointestinal cancers, especially colon cancers, can cause partial or complete narrowing or blockage of the bowel lumen – a condition called bowel obstruction. Tumors from outside such as ovarian cancer, liver cancer can press on the intestines, causing narrowing of the digestive tract. Scarring from surgery or intestinal adhesions can cause bowel obstruction, leading to constipation. Spinal cord tumor or tumor outside presses on the spinal cord, damaging nerves, causing loss of bowel movements. Metabolic disorders in the body such as high blood calcium levels, low blood potassium levels. Thyroid problems. Diabetes

Cancer patients with constipation often have the following symptoms:
Passing stools 3 times/week Feeling of not emptying stools, but using measures to stimulate defecation Hard and small stools, sometimes even described as goat feces Abdominal pain, abdominal distension, bloating, feeling of cramping abdominal pain Frequent belching, nausea or vomiting, and frequent bowel movements

In cancer patients, constipation is a common but manageable symptom. Depending on the cause of constipation, there are different treatments. Without proper treatment, constipation caused by cancer can damage the bowel lumen or rectum, causing dehydration or intestinal obstruction, making constipation worse. Constipation can also slow absorption of oral medications. Treatment of severe constipation requires a combination of diet and medication. Specifically, the measures to treat constipation in cancer patients are as follows:
It is important to ensure an adequate and balanced diet of nutrients, especially fiber, for cancer patients, to prevent exhaustion caused by cancer, and help prevent constipation. Fiber supplements can be used. However, if a patient has a tumor or scar tissue that narrows the bowel lumen, fiber can accumulate behind the narrowed bowel. As a result, your doctor will likely recommend a low-fiber diet. Cancer patients should eat a variety of foods, prioritize nutritious foods, avoid packaged foods or industrial foods such as canned meat, instant noodles, sausages... The amount of vegetables in each meal. about 200-250 grams. Fruit about 250-300 grams per day, 100-150 grams each time. Drink more water Should use sprouted rice or brown rice, nuts such as peanuts, sesame... Use drugs that support intestinal motility or stimulate bowel movements, laxatives, rectal suppositories, enemas but must be prescribed and guided by a doctor. Adjust dose, stop medications that cause constipation, or switch to another medication. In addition, patients with constipation due to cancer should increase physical activity and exercise regularly. Daily exercise should be about 60-90 minutes, suitable for physical condition, can be divided into several times a day. For severely ill patients who cannot move on their own, family members can support them.