Constipation

Constipation is very common in people with breast cancer as it can be caused by both the cancer and its treatment.
When you’re constipated, you may:

• find it difficult to poo (‘open your bowels’)
• pass hard, dry bowel motions, less often than normal.

Constipation can make you feel very uncomfortable and unwell. Working out what is causing it will help you get the right treatment and reduce your risk in future.

If you’re concerned, speak with a member of your treating team.

It’s important to tell your doctor or nurse if you are constipated for 3 days or more so they can help you to manage it.

Drugs that cause constipation

Some of the common things that cause constipation are:

• some chemotherapy drugs
• anti-nausea drugs (antiemetics)
• pain medications such as morphine and other opiates
• taking too many anti-diarrhoea medications.

Changes that can make you constipated

When you are having treatment for early or metastatic breast cancer, you may:

• change your diet, for example, reducing how much fibre you eat
• be less physically active
• not drink enough water.

Symptoms of constipation

Signs you may be constipated include:

• hard, dry bowel movements that are difficult to pass
• no bowel motions for 3 days, or less often than you usually do
• pain or cramps in your abdomen
• abdominal bloating or a feeling of fullness in the abdomen
• feeling that your bowel is not fully emptied after you poo
• reduced appetite.

Tips to reduce constipation

• To help prevent or improve constipation, try to do some of the following:
• Start a light exercise routine, such as a daily walk or swim.
• Drink more water. Taking frequent sips throughout the day can be a good way to increase how much you drink overall.
• Eat small amounts of food regularly as this is often easier to digest.
• Eat plenty of fresh fruit, vegetables, grains and high-fibre foods such as wholemeal breads and cereals.
• Speak to your doctor about medications (laxatives such as Coloxyl with senna and Movicol) that can help. Taking these regularly is very effective for medication-related constipation.
• Talk to your doctor about whether you should change your pain medication.

What to limit or avoid

• caffeine in foods and drinks
• lactose products such as milk, ice cream and cheese
• alcohol
• fibre supplements (such Fybogel or Metamucil). These are likely to make constipation worse when if the cause is cancer treatments or the cancer itself.