MANAGING YOUR BOWELS

Constipation (having a bowel movement less often than is usual for you) may be a side effect of medicine that you take or it may be associated with the foods you’re eating. Your stools may be small, hard and dry, making them harder to pass. Everyone is different, and some people have a bowel movement each day, and others have one less often, maybe three times a week. There may be a problem for you if you notice that you are having bowel movements less often than is yournormal, or if you’re having pain associated with your bowel movements.

Taking narcotic pain medicine often leads to bowel problems.  These medicines slow the movement of waste through the colon.  When this happens water is absorbed from the waste.  The result is that the stool is dry and hard.  Medicines for anxiety, depression, stomach antacids, diuretics, some vitamins, and sleep will also add to this problem.

A good diet will go a long way to help prevent constipation.  Liquids and fiber are two areas to focus on.  They can help you manage your bowels.  Liquids like water and juice will help add fluid and bulk to the waste while it is in your colon.  Fiber will add bulk and soften the waste so that the stool is not hard to pass.  Adding more liquid and fiber may solve your bowel problems.

If you are taking pain medicines, you should try to have regular bowel movements.  Here are some tips that are helpful:

  • Drink 8-10 (8 oz) glasses of water per day, and more if you’re physically active.  This should include what you drink with meals. You may choose to add 100% fruit juice which can help, but try to limit that to 1 cup per day.
  • Probiotics or yogurt may help with constipation. Many forms of probiotics are available over the counter at your pharmacy or supermarket. These help by stimulating the “good bacteria” in your gut.
  • Add more fiber to your diet by eating more fruits (raisins, prunes, peaches, and apples), vegetables (squash, broccoli carrots, and celery), and whole grain cereals, breads, and bran.  25 grams of fiber is how much you should have each day in your diet.  Read labels and see how much you are getting each day.  If you need to increase the amount, do it over time, not over night. Increasing your fiber intake can make you feel a little bloated or gassy. Just remember to drink plenty of water along with it, and those feelings should ease after your body becomes used to the increased bulk.
  •  Following is a list of some foods and their fiber content (many cereals and meal on the go bars are available with higher fiber options):

Kidney beans1 cup cooked11.3

Lentils1 cup cooked15.6

Split peas1 cup cooked16.3

Dried plums1 cup raw4.7

Apple with skin1 small2.5

Peach with skin1 larger2.4

Broccoli1 cup raw2.4

Tomato1 large raw3.4

Wheat bran flake cereal1 ounce4.9

Whole wheat bread1 slice4.1

Brown rice½ cup cooked1.8

Always drink more liquids when eating more fiber.  If you don’t take in enough liquid, that will make things worse.

  • Stay active and exercise to help to keep your bowels normal.
  • Using laxatives or enemas may add to the problem.  If you are using these products daily, you should talk with your healthcare team about other options. Using these frequently may over time cause your bowels to not work properly on their own.
  • Try to drink a warm or hot drink about one half-hour before your usual time for a bowel movement. Some dieticians suggest warm prune juice (but this can be a little hard to take if you don’t like prune juice).
  • There are many medicines that may help.  Some of them are bulk-forming laxatives, lubricants (mineral oil, liquid petrolatum), suppositories (glycerin, bisacodyl, senna), and stimulants.  These may be helpful.  Call your doctor to find out which one will work best for you.

When Do You Need to Seek Help?
Talk to your doctor or nurse about constipation.  They may have more ideas about medicines to help you manage your bowels.

Useful websites:
National Cancer Institute
Constipation and Chemotherapy
Causes of constipation
Constipation: System specific

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