chronic constipation

asstchief

My husband has severe constipation from 2 episodes of cancer with multiple surgeries, chemos and radiation. Oncologist doesn't take this seriously. Anyone else with this issue.

amr2662

Common Problem
Sorry to hear of your husbands problems. Constipation can be quite common. You didn't say what type of cancer your husband is dealing with. Lots of medications can cause constipation especially pain medicine. My doctors had me on a stool softner/laxative combo as soon as they increased my pain medicine to prevent constipation. If his oncologist won't help you find a doctor who will. He should not have to suffer. Does your husband have a gastroenterologist? If not a primary care doctor should be able to help. There are many over the counter products as well. My GI recommended the Miralax type.

Best of Luck

AussieMaddie

My toolbox for constipation
Hi asstchief,

Before getting cancer, I had had a long and serious battle with constipation when I was on a weight-loss drug. I tried everything, researched it over weeks.

Finally, I arrived at a regimen that worked well. There are different types of laxatives. A quick look online now gives me one website which lists a number of types:

http://www.colonhealthinfo.com/constipation/types.html

In the end, I found that it required a combination of things:

1) You must drink a minimum of fluid a day. Some people say at least two litres. I found that 1.5 litres was often enough, but your husband may have to work that out for himself. If he is allowed to drink a lot, I would aim for 2 litres a day. It can be in any form, but I wouldn't include milk products as fluid. It may not be easy to remember to drink so much, but have him keep a 2 litre jug of water next to him all day and time it. Divide the 2 litres into the number of hours till 2 hours or so before bedtime, to give himself time to have a move before he goes to bed. Having divided that amount into the number of hours, make sure that he drinks at least that amount each hour. You can flavour it in different ways if he prefers. Herbal tea, fruit juice, cordial etc. (Watch ordinary tea and coffee which act as mild diuretics. Not sure, but I think beer is too)

2) Eat high fibre foods, &/or take fibre supplements to increase the bulk of his stool. I used to eat wholemeal bread until a dietician told me that wholegrain bread was better for fibre. Another food naturally high in fibre are prunes. Check online. You'll find lots of others. There are also cereals high in fibre. Compare the ingredients on the boxes.

3) If he finds it hard or painful to pass, start him on a stool softener. These are much safer to take than the type of laxative that makes the bowel work harder. They work by causing fluid to be absorbed into the bowel, which then softens the stool before it is passed. This made the biggest difference to me. I used liquid types. I think Lactulose is the generic name. Another type is Movicol (don't know the generic name) It's a powder that you add to water. Not great either. I found the Lactulose worked better. It's terrible to drink, horribly sweet, but I would never be without a bottle. The single best thing I ever used for constipation. (I admit to using much more than is given on the bottle - though it can give you diarrhea if you take too much)

Stimulant type of laxatives which make your bowel push harder only cause more pain if the stool isn't soft enough. That's why the Lactulose or Movicol is so important. The stimulant types also cause the bowel to develop a dependence on them, causing it to lose it's natural function over time.

Another type to avoid are those like senna and cascara. This type can, over a long time, cause the lining of the bowel to become dark in colour (called ' melanosis coli'). If you look that up that online you will see something like the following from:

http://www.medicinenet.com/melanosis_coli/page2.htm

" Early studies suggested that anthranoid laxatives might have carcinogenic or tumor-promoting activities in humans and that the presence of melanosis coli might signal an increased risk for the development of colorectal cancer

4) I am never without my glycerine suppositories. The nurses in the hospital introduced me to those disposable rubber gloves before inserting one else it's just a matter of thoroughly washing your hands afterward.
They are totally safe. When he can tell that there is something to pass but he can't move it, insert the gelatine suppository as far as possible into the rectum. (I've often used two, but start with one to see if that's enough.) It will melt inside and mix with the stool to soften it - but be ready for it to move very quickly after about half an hour.

One note about brands of these glycerine suppositories:
In the past, I was able to purchase a brand where the suppositories looked and felt like hard, white moulded soap. If you can get these hard ones, do. They are much easier to insert. (I forget the brand name now) . The only type I can find now are a gel in a capsule. They are so soft that they wiggle all the time and are almost impossible to insert. *Don't* use anything but the tiniest amount of cream to insert them because they will slide everywhere. It might help to keep them in the fridge to harden them a little, but do try to find the other brand.

5) Finally, I always keeps a haemorrhoidal cream handy for the inevitable haemorrhoids that come from straining. I put a very little on the glycerine suppository to help insert it, and spread some around the rectum afterward where the haemorrhoids are. Make sure when you buy them that they include a pain-relieving ingredient, if that is a problem.

That's what's most important in my anti-constipation toolbox.
You may already have tried many of these things. I don't know, but altogether, I find they can conquer any constipation.

I should add that my mother once had such severe constipation that she had to go to the doctor to have him insert some type of enema. And more recently, a friend gave me a supply of Microlax enemas which her husband no longer needed. I've never tried those but will keep them in mind. They are almost certainly easier to insert than the silly gel-filled capsules I'm working with.

Hope that helps.

Take good care,

AussieMaddie

nowrest

AussieMaddie said:

My toolbox for constipation
Hi asstchief,

Before getting cancer, I had had a long and serious battle with constipation when I was on a weight-loss drug. I tried everything, researched it over weeks.

Finally, I arrived at a regimen that worked well. There are different types of laxatives. A quick look online now gives me one website which lists a number of types:

http://www.colonhealthinfo.com/constipation/types.html

In the end, I found that it required a combination of things:

1) You must drink a minimum of fluid a day. Some people say at least two litres. I found that 1.5 litres was often enough, but your husband may have to work that out for himself. If he is allowed to drink a lot, I would aim for 2 litres a day. It can be in any form, but I wouldn't include milk products as fluid. It may not be easy to remember to drink so much, but have him keep a 2 litre jug of water next to him all day and time it. Divide the 2 litres into the number of hours till 2 hours or so before bedtime, to give himself time to have a move before he goes to bed. Having divided that amount into the number of hours, make sure that he drinks at least that amount each hour. You can flavour it in different ways if he prefers. Herbal tea, fruit juice, cordial etc. (Watch ordinary tea and coffee which act as mild diuretics. Not sure, but I think beer is too)

2) Eat high fibre foods, &/or take fibre supplements to increase the bulk of his stool. I used to eat wholemeal bread until a dietician told me that wholegrain bread was better for fibre. Another food naturally high in fibre are prunes. Check online. You'll find lots of others. There are also cereals high in fibre. Compare the ingredients on the boxes.

3) If he finds it hard or painful to pass, start him on a stool softener. These are much safer to take than the type of laxative that makes the bowel work harder. They work by causing fluid to be absorbed into the bowel, which then softens the stool before it is passed. This made the biggest difference to me. I used liquid types. I think Lactulose is the generic name. Another type is Movicol (don't know the generic name) It's a powder that you add to water. Not great either. I found the Lactulose worked better. It's terrible to drink, horribly sweet, but I would never be without a bottle. The single best thing I ever used for constipation. (I admit to using much more than is given on the bottle - though it can give you diarrhea if you take too much)

Stimulant type of laxatives which make your bowel push harder only cause more pain if the stool isn't soft enough. That's why the Lactulose or Movicol is so important. The stimulant types also cause the bowel to develop a dependence on them, causing it to lose it's natural function over time.

Another type to avoid are those like senna and cascara. This type can, over a long time, cause the lining of the bowel to become dark in colour (called ' melanosis coli'). If you look that up that online you will see something like the following from:

http://www.medicinenet.com/melanosis_coli/page2.htm

" Early studies suggested that anthranoid laxatives might have carcinogenic or tumor-promoting activities in humans and that the presence of melanosis coli might signal an increased risk for the development of colorectal cancer

4) I am never without my glycerine suppositories. The nurses in the hospital introduced me to those disposable rubber gloves before inserting one else it's just a matter of thoroughly washing your hands afterward.
They are totally safe. When he can tell that there is something to pass but he can't move it, insert the gelatine suppository as far as possible into the rectum. (I've often used two, but start with one to see if that's enough.) It will melt inside and mix with the stool to soften it - but be ready for it to move very quickly after about half an hour.

One note about brands of these glycerine suppositories:
In the past, I was able to purchase a brand where the suppositories looked and felt like hard, white moulded soap. If you can get these hard ones, do. They are much easier to insert. (I forget the brand name now) . The only type I can find now are a gel in a capsule. They are so soft that they wiggle all the time and are almost impossible to insert. *Don't* use anything but the tiniest amount of cream to insert them because they will slide everywhere. It might help to keep them in the fridge to harden them a little, but do try to find the other brand.

5) Finally, I always keeps a haemorrhoidal cream handy for the inevitable haemorrhoids that come from straining. I put a very little on the glycerine suppository to help insert it, and spread some around the rectum afterward where the haemorrhoids are. Make sure when you buy them that they include a pain-relieving ingredient, if that is a problem.

That's what's most important in my anti-constipation toolbox.
You may already have tried many of these things. I don't know, but altogether, I find they can conquer any constipation.

I should add that my mother once had such severe constipation that she had to go to the doctor to have him insert some type of enema. And more recently, a friend gave me a supply of Microlax enemas which her husband no longer needed. I've never tried those but will keep them in mind. They are almost certainly easier to insert than the silly gel-filled capsules I'm working with.

Hope that helps.

Take good care,

AussieMaddie

Prune Juice
I get constipated right after each Chemo treatment. I have found that Milk of Magnesia and good old prune juice keeps things moving.

Bramasole

Chronic constipation
This was a recurring problem for me until I started taking "pearls" which is a pro-biotic that helps with colon health. Hope this helps.