Ann Arbor Hematology Oncology Associates PC

Information About Constipation

DEFINITION: A decrease in your normal frequency of bowel movements (BM). Stools may be small or hard, and passing them may be difficult, painful, or impossible. You may also have bloating or cramping.

CAUSES: Illness, side effects of treatment, decrease in activity, lack of liquid in the diet, and emotional distress may cause constipation. Pain and nausea medications and some chemotherapy drugs can cause constipation.

PREVENTION:

	Increase liquids to at least 6-8 glasses of water.
	Increase fruits, vegetables, grains, and fiber, in your diet.
	Limit starchy foods and cheeses.
	Increase physical activity.
	Establish a daily routine that allows you adequate time and privacy.
	Use stool softeners and laxatives.

TREATMENT: We recommend using Senokot-S (senna concentrate & docusate sodium). A suggested starting dose for prevention is 2 tablets at bedtime. Senokot-S can be increased or decreased as needed and you may take up to 8-10 tablets a day. If your stools become loose or you are having BM's more than once a day you may want to decrease the number of pills that you are taking until you are going on a regular basis, and stools are formed and easy to pass.

MILD CONSTIPATION: No BM for 1-2 days longer than usual.

Increase the amount of Senokot-S and ad wither Milk of Magnesia or 2-3 Dulcolax tablets.

MODERATE CONSTIPATION: No BM for 2-3 days longer than usual.

Increase Senokot-S and add magnesium citrate or Dulcolax suppository.

SEVERE CONSTIPATION: No BM for 4-5 days longer than usual.

Increase Senokot-S and use a Fleets Enema or Fleet Phopho-Soda.

Remember that everyone is different and there are no set rules to manage constipation, only guidelines. Drugs and doses may need to be changed from time to time as your condition and medications change. Please feel free to call our office and ask one of the nurses to help you if you have any questions or concerns.

Contact our office if you have: Nausea or vomiting Bleeding from the rectum or blood in your stools abdominal pain or bloating.

Some of the medications that can cause constipation:

Morphine

Percocet

Oycontin

Roxicet

Roxanol

Codeine

Dilaudid

Duragesic

MS Contin

Zofran

Kytril

Velban

Vincristine

Anzemet