Constipation is a common side effect of types of cancer treatment.  It is defined as having three or fewer bowel movements per week, often involving stool that is hard and difficult to pass.  Bowel movements may also feel incomplete and cause a feeling of fullness that can make it more difficult to eat. 

Common causes of constipation during cancer treatment include the following: 

• Changes in diet that reduce fiber intake 

• Inadequate hydration 

• Less physical activity 

• Pain medications 

• Some anti-nausea and antidepressant medications (among others) 

Managing constipation often requires a combination of diet, hydration and medications (discussed below).   It is important to communicate with your clinical team if you’re experiencing constipation as it’s easier – and more comfortable – to treat constipation early than to wait until it’s severe. 

Remedies for Preventing and Treating Constipation 

Eating a diet high in fiber is the first defense against constipation, though if you’re struggling to eat due to side effects of treatment that can be challenging.  Fiber is found in plants, so increasing your intake of fruit, vegetables, whole grain breads, crackers and cereals, brown rice, quinoa, legumes, nuts and seeds whenever possible is helpful.  Here are some tips to increase fiber in your meals and snacks: 

• Opt for whole or dried fruit instead of juice. 

• On labels of breads, cereals and crackers, look for the word “whole” in the first ingredient, such as “whole wheat flour” and “whole grain oats.”  

• Look for foods labeled as “high fiber,” which means at least 5 grams of fiber per serving; a “good source of fiber” contains at least 2.5 grams of fiber per serving.  

• Choose brown rice, quinoa or whole wheat pasta as your starch for meals.  High fiber pastas made with beans and lentils are also available. 

• Mix flax meal, wheat germ, unprocessed wheat bran, chia seeds or cacao nibs into cereals, whole grain side dishes, smoothies and salads to boost their fiber content.  

• Blend beans into rice dishes, salads, and wrap sandwiches.  Snack on hummus dipped in corn chips or sliced vegetables. 

• Snack on nuts or add them to hot or cold cereals, yogurt, and salads; spread nut butter on crackers and toast.   

The following is a sample list of foods and their fiber content per serving: 

Additional Strategies for Managing Constipation 

Many time-honored tips exist to help prevent or treat constipation.  See if any work for you. 

• Drink warm prune juice, snack on dried prunes or mix stewed prunes into applesauce or yogurt. 

• Aim for at least 8 cups of water and other fluids per day.   

• Get some physical activity each day as often as possible. 

• Eat regular meals and snacks to provide opportunities to increase fiber intake.  

• Sip on senna tea, such as Smooth Move tea by Traditional Medicinals 

• For bloating and gas, avoid carbonated beverages, chewing gum and hard candies, and drinking from a straw, all of which promote swallowing more air.  Try using Beano (an enzyme supplement that breaks down fibers) before eating high fiber foods. 

Fiber Supplements 

Some people benefit from adding fiber supplements to their daily routine.  Examples include Benefiber, Metamucil and Citrucel.   Start with one dose daily mixed with 8 oz of water or other fluid, increasing every 2-3 days to a maximum dose of three times per day.  Speak to your healthcare team for guidance specific to your situation.