Constipation and Cancer: How are they connected?

Overcome constipation with consistent effort and a little discipline.

"If you concentrate on small, manageable steps you can cross unimaginable distances.” ― Shaun Hick

Whether due to surgery, chemotherapy, pain medications or because of other medical conditions, constipation or difficulty in passing stools can start as an uncomfortable feeling and progress to a painful affair. How you manage it depends on how you define the kind of constipation you experience. The condition is relative, referring to a shift from the normal in bowel movement for a person. Normal bowel movement can vary from once or twice a day to onee in two days even. One definition of the condition is the "four toos – stools that are too hard, too small, too difficult to expel, and too infrequent".

Constipation is reported by nearly 50% of patients receiving chemotherapy.


Talking to your cancer care team is always the right thing to do to nip this problem in the bud but there are small changes that you can do even prior to starting treatment that can be very helpful as you go through treatment and afterward.

Here are some suggestions that can help prevent or even treat constipation-

  • Establish mealtimes and stick to them.

  • Digestion begins in the mouth, so take time to sit and focus on your meal and chew slowly and thoroughly. 

  • Try to have a bowel movement at approximately the same time every day. This may take some time but your body will get used to it if you are consistent.

  • Slowly try to increase the amount of fiber in your diet and eat naturally high fiber foods such as lightly steamed vegetables and salads, lentils, raisins, fruits such as prunes, dried apricots and whole grains. Be careful with raw vegetables and certain raw fruits as they can sometimes be difficult to digest when you are on treatment. If you add fiber you must proportionally increase your water intake as well. If you have an ostomy or bowel surgery make sure to talk to your cancer care team before adding fiber to your diet.

  • Drink at least 8-10 glasses of 8 ounces of warm water every day. You can add lemon, lime or mint to the water if you like.

  • Limit caffeinated drinks to 1 per day. Caffeine can be dehydrating which can worsen constipation.

  • Limit processed foods as much as possible. There is a reason they are called junk - they deserve to be trashed not eaten.

  • Try and exercise daily. Even walking at a pace that is comfortable to you every day for 30 minutes can help with regularizing your bowel movements.

  • There is a great yoga pose that can help with bowel movements, it is called Malasana or the garland pose. Malasana tones the abdominal muscles and improves the function of the large intestine to help with elimination. Start slowly, be consistent and always pay close attention to how your body feels. If you have knee injuries or issues, this pose is not for you. Here is a video link that describes the pose:

  • Use a squatting stool- a stool that nests against your toilet and elevates your feet, converting your “sitting” posture to a “squatting” posture. This creates an easier pathway for elimination by relaxing the puborectalis muscle and straightening your large intestine.

  • Lastly, any over-the-counter meds including laxatives, stool softeners,suppositories or enemas should be taken only after talking to your physician.

Is constipation a serious issue? Well, it makes you uncomfortable and affects how you feel. That’s a good starting point. If left untreated, it can lead to a bowel obstruction. In case you are undergoing pelvic radiotherapy, constipation can affect your treatment as well. Constipation is medically treated with meds that work in different ways. You may have heard of over-the-counter laxatives, aperients, suppositories or enemas. It is very important to take these medicines only after you have spoken to your doctor.

Anyways the point is, you don’t have to be stuck with constipation. You can flush it out; you just need to know how.

Reason to hope: A triple drug combination of encorafenib, cetuximab, and binimetinib resulted in significantly longer overall survival and a higher response rate than standard therapy in patients with metastatic colorectal cancer with the BRAF V600E mutation.

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Reason to Hope

A plant-based whole food diet reduced gingivitis in a recent randomized trial published in the Journal of Clinical Periodontology. The study results demonstrate the possibility to naturally reduce gingivitis by an optimized diet that also promotes general health.

Journal of Clinical Periodontology, 2019; DOI: 10.1111/jcpe.13094