CONSTIPATION— or difficulty having bowel movements—is a common gastrointestinal complaint among all ages and populations in the United States, affecting approximately 16 percent of American adults according to the National Institutes of Health. Some people experience constipation only occasionally, while for others the condition is chronic. Minor, short-term cases that impact quality of life can usually be resolved with at-home care and lifestyle changes, while more severe cases may require medical intervention.
Supplying a precise definition of constipation is difficult because what’s normal for one person in terms of bowel habits may be unusual for another. However, Brittany Zenk, CNP, of The Toledo Clinic Cancer Centers explains that constipation is most commonly defined as having fewer than three stools per week combined with symptoms such as hard stools, bloating, abdominal cramping, straining on the toilet, and the feeling of incomplete defecation.
She adds, “Constipation becomes a medical concern when the individual is having pain after a week or more without a bowel movement. Megacolon, or the abnormal dilation of the colon, can be a symptom of severe stool buildup as well. If there is no passage of gas, there’s a concern of blockage, which is a medical emergency requiring the patient to be admitted.”
Zenk notes that among cancer patients, the odds of getting constipated are about 50/50. “Ironically, treatments cause diarrhea in some patients. Others become blocked up because they’re dehydrated and not eating as much,” she says. Both conditions can be managed effectively, so patients experiencing either bowel issue are urged to share that information with their care team.
Several factors can cause or contribute to constipation, such as being dehydrated due to inadequate water intake, not getting a sufficient amount of fiber in one’s diet, and not getting enough physical activity. “Medications are another major culprit,” Zenk states. “Many of the new medications on the market today, for instance certain pain-management and blood-pressure-lowering drugs, cause changes in the body that can lead to constipation.”
Also, it’s important to note that dietary changes—even for the better— can cause constipation as the body adapts to the change. “For example, if you’re used to eating mostly processed foods but then decide to incorporate a lot more fiber-rich and nutrient-dense foods than your body is accustomed to, you can actually get blocked up. Fiber is still good for constipation, but your body needs time to adjust to it and too much all at once can actually cause constipation,” Zenk says. To prevent constipation, she recommends drinking plenty of fluids to keep stools moist instead of dry and hard, as well as incorporating fruits and vegetables with edible skins into your daily diet—again, taking care not to go overboard.
For those who are already dealing with constipation, numerous treatment alternatives are available, starting with very conservative athome remedies. “Sometimes patients can get relief by incorporating probiotics in their diet, either from yogurts or supplements such as Align
. If that doesn’t work, we can try medications such as MiraLAX
, which should be taken under the direction of a provider and is great for increasing moisture in the stool, or Senokot
, which combines a stool softener and laxative. In some cases, laxative suppositories like Dulcolax are necessary, but you have to use them with caution because the body can become dependent on them,” says Zenk.
Oftentimes, patients ask Zenk for a more holistic approach to treating constipation, and she can offer them several suggestions that fit the bill. “One is probiotics, and another is Smooth Move
Tea, which contains the natural laxative senna. A few other holistic options include prunes or prune juice, and a mixture of prune and apple juice warmed up with a teaspoon of butter. Whether we’re
n using medications or a more holistic approach, it comes down to finding out which technique or combination of techniques works best for the individual patient,” Zenk says.
The Toledo Clinic Cancer Centers, located at 4126 N. Holland Sylvania Ro ad, Suite 105, also provides imaging, laboratory, chemotherapy, specialized pharmacy, and IV services. The cancer center consists of 10 medical and 3 radiation oncologists along with 9 advanced practice providers. The cancer center also has satellite centers in Maumee, Napoleon, Bowling Green, Wauseon, and Monroe.
The Toledo Clinic Cancer Centers has earned Patient-Centered Specialty Practice recognition and Oncology Medical Home recognition from the National Committee for Quality Assurance. Oncology homes align systems and resources with coordinated care focused on cancer patients and their needs. This reduces fragmentation, supports shared decision making, and improves the patient experience. They are the first oncology practice in the state of Michigan and the second oncology practice in the state of Ohio to receive this recognition.
For more information, please call The Toledo Clinic Cancer Centers at 419-479-5605. ✲
