(Before writing about this topic, I asked him if he really wants me to post about his constipation problems and he said yes, so here goes....)
Constipation is a common and frequently troublesome symptom in patients with advanced cancer. Despite its prevalence, constipation can still be an overlooked symptom, which often receives little attention until significant problems occur. Often, multiple causative factors are present:-
o Reduced food (including fibre) and fluid intake
(e.g. opioids, drugs with anticholinergic action, antagonist anti-emetics, iron). Opioid use is strongly associated with constipation in patients with advanced cancer. Opioids have a constipating effect whether given orally, sub-cutaneously or transdermally, although the incidence of constipation may be reduced with non-oral administration
o The cancer itself
Treatment of Constipation
In Chang's case however, laxatives have not worked. In cases of constipation it is important not to wait if there is no bowel movement for a few days. He told me that he was too embarassed to accept help during an earlier visit to the hospital. (when a nurse asked him if he wanted an enema administered). So, during his recent stay at the hospital last week, he asked for assistance and this time, the nurse administered the enema for him but it was unsuccessful. Back home, he has tried what he calls the "tin mining approach" ie using water to spray up the anus but has still not been successful.
The Hospis Malaysia nurse will be visiting tomorrow. Hopefully, there will be a breakthrough.
(Updated by Chang's friend)