Constipation Lifestyle guidelines and dietary tips

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Constipation is common complaint during cancer therapies and otherwise. This is usually brought on by the general disruption of the daily routine resulting from extra travelling, stays in hospital or waiting in hospital waiting rooms. Other contributory factors include:

• anti-sickness medication (eg ondansetron) and pain killers (codeine or morphine) are additional major culprits

• not eating enough fibre

• not being active enough

• drinking an excessive amount of strong tea or coffee (these can be dehydrating)

• bowel muscles weakness – being frail or recent abdominal surgery

• haemorrhoids, or anal fissure can make it painful to defecate

Symptoms of constipation  
We are all familiar with the symptoms of constipation which most commonly include an uncomfortable feeling in the back passage, bloating and abdominal cramps. There are many other symptoms which are not so immediately obvious. A recent survey of patients with regular constipation reported the following symptoms:

• 65% mentioned discomfort, fatigue & apprehension
• 25% reported irritability and increased arguments with their partners
• 51% admitted feeling less attractive, impacting their social lives
• 38% said they cancelled or left a social engagement early
• 68% said it affected sex either because they felt unattractive or in pain
• 70% reported embarrassment with the extra associated flatulence.

Despite the frequency of this complaint, it is often looked and only addressed when it becomes a significant problem. With some logical foresight however constipation can often be prevented. For example if anti-sickness drugs such as ondansetron are give with chemotherapy consider changing the diet the day before chemotherapy (especially if constipation has been a problem in previous cycles). Try eating three or four dried prunes (or something equivalent if you don’t like prunes) the night before and the morning of chemotherapy. Immediately after chemotherapy it is more difficult to modify diet as there is usually some impairment of appetite but not to worry the fibre will already be in the system. Another good manoeuvre is also to try and go for a brief walk in the fresh air in the evening after the chemotherapy – this may seem alien but not only will it help prevent constipation but it will help the nausea.  Painkiller such a codeine also commonly cause constipation; consider changing the diet before the stools harden rather than wait for the uncomfortable circle of complaint setting it and self perpetuating.

Ways to prevent constipation

• Eat plenty of fibre such as bran, wholemeal bread, cereals, fruit, leafy vegetables, potato skins, beans, dried peas (see below).

• Have a regular routine in the morning and allow your bowels time to work. The best time to go is in the hour after breakfast

• Don’t ignore the call to stool – if you want to go – go don’t be embarrassed to keep people waiting while you sit on the loo with the newspaper until you’ve had a good result.

• Exercise shakes up your bowels and reduces the time motion takes to pass through your bowels (transit time) - your stool will be softer by the time it reaches your rectum easier to pass.

• Use ointment, suppositories to relieve a painful anus.

Dietary tips and constipations

Fruit Try including more fruit in your diet, either tinned, fresh, stewed, pureed or dried.

• Add dried fruit to porridge, cereal or milk puddings
• Slice a banana on your breakfast cereal
• Slice fruit on to desserts such as mousses and cheesecakes

Vegetables and Salad  Try increasing your intake of vegetables including peas, beans and lentils. These can be fresh, frozen, tinned, cooked or raw:-

• Add cauliflower, leeks or broccoli to stews, casseroles, curries, and soups
• Include salad in sandwiches
• Baked beans on toast makes a high fibre snack / meal

Breads and Cereals Eat more wholemeal / wholegrain / granary bread, rolls, pitta bread, chapattis or wholemeal scones etc.

• Cereals such as Branflakes, Weetabix, Porridge, Shredded Wheat or Fruit & Fibre are a good source of fibre.
• Digestive and oat biscuits contain more fibre than plain biscuits such as Morning Coffee or Rich Tea.
• Cereals such as Branflakes, Albran or Fruit & Fibre can be mixed with lower fibre cereals such as cornflakes or Frosties to increase their fibre content

Helpful resources and links

Cancernet-UK: What is cancer;  About specific cancers; Breast | Prostate | Bowel.  About cancer treatments; Chemotherapy | Radiotherapy | Hormones | Biological agents | Complementary.  Lifestyle advice; Exercise | Diet | Smoking | Sunbathing | Alcohol.  Cope with symptoms;  Traveling | Insurance  | Tests for cancer | Clinical trials. ...site map

Micro-nutrient testing Empower yourself to make dietary choices specific to your personal make up. This Cancer Risk Nutritional Profile, analyses your blood profile and recommends specific dietary and supplement advice to ensure you have the best possible nutritional status to fight cancer an aid recovery from treatments....read more

Download a free chapter describing how to avoid cancer forming chemicals (Carcinogens) in our diet and environments  from the new edition of the best selling evidence based book    "Lifestyle after Cancer - the facts"

Make a will (or living will)  Cancernet has teamed up with a leading UK lawyer to drive down the cost of making a solicitor checked will.  This reliable, easy to use, online resource ensures your assets (money, property, jewellery, etc) go to the person you want and not those you least want. Cancernet-glossLegal wills start from £39....read more

Protect your lips during chemotherapy There is evidence that natural oil based creams are better than petroleum based creams. natureMedical lip balm has been specifically design to soothe and moisturise the lips during and after chemotherapy or after sun exposure. It only contains only natural waxes and essential oils selected for their anti-inflammatory and DNA stabilizing properties...read more/order

Protect your nails during chemotherapy. Nails can become painful and disfigured during and after chemotherapy. We describe the latest nail care guidelines and  number of useful tips to keep them healthy, including cooling and moisturizing ...read more

Poems and cancer   Cancer is emotional and stressful time not only for the patients but friends and relatives. This emotional can inspire reflection, sentiment and creative writing and poetry. Hundreds of poems have been kindly submitted by users of cancernet. Caution: take a tissue some of these are real emotional bombshells!.. Read poems or...submit your own poem

Look after your family after cancer - A diagnosis of cancer can cause a strain on family harmony. With emotions running high its not a good time to be upset further by destructive arguments. This practical little book has identified the situations where arguments are most likely to happen and provides simple tips to navigate around them...download £1.99

Lifestyle and cancer - the facts. This 2011, edition with a foreword from Paula Radcliffe has been extensively re-written with evidence from the latest research from around the world which demonstrates how diet, exercise and lifestyle changes can; help avoid cancer (read chapter 9 free), cope with treatments side effects; slow the rate of progression of cancer and help prevent  relapse.  This comprehensive essential lifestyle guidebook can be ordered online (£8.95), or downloaded via kindle

Prepared for cancer treatments. Patients and professionals, teamed up with Sue Lawley to produce this 21 minute film which explains chemotherapy & radiotherapy while you watch patients, describing their experiences, side effects and methods to alleviate them. Awarded the NHS communication prize ...  read more / order individually or in bulk for your oncology department

Keep-healthy.com Practical evidence based advice on healthy living including ways to naturally reduce cholesterol, reduce blood pressure, keep healthy eyesight, hearing, maintain a healthy weight and level of fitness. Includes advice on supplements and other useful products...link

Support groups and self help organisations throughout the UK and internationally. Links to Asian support organisations; Read patient stories, poems and links to the Cancer active website addressing a wide range of complementary issues related to cancer and their a quarterly magazine (ICON)..  submit a link to your group