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Palliative Care Platform

Palliative Care Platform

Symptom Management >Constipation

About Constipation

  • Constipation refers to dry and hard stools, difficulty in defecation or sudden decrease in the frequency of bowel movements. Possible causes include:
    • Side effects of medications
    • Physical weakness, lack of energy to pass stool
    • Tiredness and prolonged rest in bed, lack of exercise
    • Poor appetite, insufficient intake of water, fruits and vegetables/ fibres
    • Electrolyte imbalance in the body, such as high blood calcium
    • Mental stress, anxiety and depression
    • Tumour compressing or blocking the intestines
  • Constipation makes people feel uncomfortable; it may trigger other symptoms such as nausea, vomiting, loss of appetite, bleeding haemorrhoids, abdominal distension and pain
  • If constipation occurs, notify the healthcare professionals for follow up immediately

Medical Treatment

  • Healthcare professionals will provide appropriate treatment based on the causes of the symptoms. If necessary, doctors may prescribe medications
  • If the constipation is caused by pain medications, it can be relieved with the use of laxatives prescribed by the doctor
  • Depending on the situation, doctors may prescribe laxatives. There are different types of medications which should be taken or used according to the instructions of doctors:
    • Senna stimulates the peristalsis of large intestines; Lactulose increases the water content in the large intestines, and Colace softens the stool. If you have abdominal pain or diarrhoea after taking the medications, notify the healthcare professionals for adjustment of the dosage. Do NOT stop taking the medications on your own
    • Anal suppositories, such as Bisacodyl rectal suppository, promote intestinal peristalsis and help with defecation. Apply lubricants to the head of the suppository and insert it about two inches deep into the anus with your finger. The suppository should stay in the rectum for more than half an hour to take effect
    • When using an enema, such as Fleet enema, make the patient lie on the left side and squeeze the bottle until the drug is in the rectum. When the patient feels the desire to defecate after a while, the enema fluid and the stool will be discharged together
  • If the patient still has no bowel movement after using laxatives, including anal suppositories and enemas, for several days, notify the doctor for further assessment

Point to Note on Daily Living

  • Record the colour, shape, quality and frequency of bowel movement every day
  • If you feel the need to defecate, go to the toilet immediately; if you are too weak to reach the bathroom, use a bed pan, commode or a diaper
  • Drink a glass of warm water on an empty stomach in the morning to stimulate bowel movement
  • If the conditions allow, massage the abdomen clockwise for about 15 minutes before bowel movement to facilitate intestinal peristalsis and stimulate the passing of stool to the rectum and anus
  • Increase activity to a level that the patient can tolerate
  • If the conditions allow, encourage the patient to drink more water and eat foods rich in fibre, such as cereals, vegetable and fruits, especially prunes, papaya and bananas (except when the constipation is caused by tumours compressing or obstructing the intestines)

Consult your medical team in case of any questions.

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