Tuesday, June 8, 2010

Chemotherapy and constipation

Here's a fun topic! Ok - cancer has rendered me shameless so if you don't want to hear about poo stop reading now. Ready?

Some chemotherapy drugs loosen your stools and some plug you up. Mine did the latter. Big time (or not so big time, if you get my drift). During the first two months of chemo, I experienced more distress at being constipated than at any other side effect. No joke - it was seriously mentally distressing to not be able to poo.

So I will give you the big heads up NOW! Do not let it become a problem. If you are proactive, you can avoid this distress.

1. Increase your intake of dietary fiber. Women are advised to consume approximately 25 grams of fibre a day. If you are constipated because of chemo, you will need to eat at least that. I turned first to lists of high fiber foods to find out what foods I could quickly and easily add to my diet. I found this list of high fiber foods and an additional chart that guides you through making choices from the various categories of foods by fiber content. My first revelation - a medium avocado has over 11 grams of fiber. A cup of cooked black beans has almost 15 grams! I started adding quacamole and garlicky black beans as side dishes to my meals to significantly increase my fiber intake, painlessly. I knew prunes were an option but now I could add in other dried fruits (figs - 3.7 grams in 2, apricots - 2.89 in 5) more appealing to my tastebuds. And for fresh fruit, the chart showed me that blueberries were a good choice (4.18 grams per cup), but raspberries (8.3) were twice as good. Grapefruit and papaya were also good choices. Cooking greens? A cup of mustard greens has 2.80 grams to collard greens' 2.58, but kale has 7.2! You get my point - using the chart made meal and snack planning much easier.

Some people will also tell you to decrease the amount of animal protein you are consuming. During chemo I didn't eat much animal protein so it was hard to cut back. But see if this works for you.

2. Drink up. Make sure you are drinking enough fluids, especially non-caffeinated ones. Best - water. Nurses will tell you to try prune juice so give it a shot. I usually ended up diluting it so I could get it down. Advice you may not hear in terms of caffeinated beverages - try some coffee. I made sure I had a big latte every morning, hold over advice from a lovely doctor who oversaw my repair after the delivery of my huge headed first baby. ;-) If coffee is what works for you in normal circumstances, it will probably work for you now. It certainly won't hurt.

3. Move your body.  Have I told you yet that my husband is a retired tank commander? The first advice out of his mouth when you are feeling crappy is either go get some exercise or suck it up. Since sucking it up was not an option, we walked. Around the block in the wind, around the block in the pouring rain. Nothing. Around the block again. Nothing. But I kept going and eventually there was a bit of, um, movement.. Every little bit of physical exercise does help your body fix the problem naturally. Plus you get additional benefits  from the exercise. 

4. Talk to your nurse or doctor about laxatives and stool softeners. What worked for me was Senokot S, a natural source laxative with an additional stool softener. I'm sorry - I should probably dance and sing here - woohoo!!! In your face constipation!! Movement of the business with no cramping at all. The key is start taking it one or two days before chemo to prevent the constipation from starting rather than trying to reverse what has already happened. A straight stool softener, docusate sodium capsules for example, is another recommended option but for me it didn't help much.

Now - my best advice - ExLax is only for the truly desperate. One pharmacist recommended Extra Strength ExLax. Good lord. The cramping was so bad it left me sweating, crying, and curled in the fetal position, something I thought I had left behind when I stopped mixing scotch and oysters. I will never take it again. All of the nurses say the same thing - try everything else before you try that.

Again, be proactive. It is easier to solve the problem when  you begin focusing on your stools a day or two before your chemo infusion.

Alright - now we're done. :-) Happy pooing!

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