First of all, allow me to state the importance of drinking plenty of water during treatment!
That said, let’s move on to #2.
No, for real, #2.
Because if you’re reading this article, you’re likely going through chemo or about to go through chemo and want an idea of what to expect. Or perhaps you have a loved one going through it and you’re educating yourself on the side effects so you can be more supportive or empathetic. The point is, if you’re reading this specific post then it’s likely because you want real information, in which case I won’t be doing you any favors by sugarcoating the facts.
(You may notice, however, this post has fewer pictures than other posts. For that, you’re welcome.)
Pre-chemo, I typically didn’t have much problem with constipation. I’m not saying I was a super-duper pooper, but I rarely felt backed up either. Generally speaking, I usually wasn’t further than one strong cup of coffee away from a gold star for the day.
I certainly wasn’t anticipating chemo constipation being an issue. Sure, I associate it with strong pain killers and take precautions in that case, but I wasn’t on any at the time of chemo.
This would be a good time for me to disclose that some people have the exact opposite problem – diarrhea is also a common side effect of chemo. (Isn’t chemo grand?)
After some research, though, I found that approximately 16% of patients can deal with Chemo-induced Constipation (CIC), while upwards of 80% deal with Chemo-induced Diarrhea (CID). Even more alarming is that CIC and CID are some of the primary factors in dose reductions and treatment delays.
I had chemo constipation for about a week after each of my first two Adriamycin/Cytoxan infusions; then I’d have a good, healthy bowel movement and I’d be fine. But my bowel movements didn’t come with rounds three and four of Adria like they had with the first two. And they continued to worsen with Taxol.
I never had to do an enema; I was fortunate in that regard. However, I did have to play catch-up for a while to get myself back on track. At my worst, I was taking a laxative, a dose of Benefiber, and two stool softeners a day. Even then, I could poop, but it was still a struggle.
The problem is, if you’re familiar with constipation, then you know this problem can rapidly get out of hand. You’re well aware that things can get very uncomfortable very quickly, and then it’s a game of catch-up to get your guts back on track.
Remember all that water you’re supposed to be drinking? This is another reason you need it! If you’re experiencing diarrhea, your body is losing water and you risk dehydration. Or if you’re constipated and have to add stool softeners to your regimen, then you need more water so they can do their job. Either way, chemo constipation and diarrhea require adequate water intake!
My advice: pay close attention to your bowel movements when you begin chemo. You may even consider keeping a log of, well, your “logs.” If diarrhea is your body’s response, then this could give you an idea of how much water you’re losing. But if you experience chemo constipation, then perhaps my experience can inspire you to act a little earlier in the game.
It got pretty painful for me there for several weeks because I had delayed doing anything about my bowel movements. “Surely I’ll poop tomorrow,” I thought, and I didn’t want to add any other medications to my ever-growing list of daily pills. By the time I could poop, it friggin’ hurt!
Save yourself the pain and discomfort and start taking stool softeners within two days of not having a bowel movement. Better yet, talk with your oncologist if CIC or CID is becoming an issue. Your oncology team should be able to give you some guidance to alleviate the discomfort while hopefully not delaying your treatment plan.
Oh, and I don’t know if I’ve said this yet, so just in case: make sure you’re drinking plenty of water.
Have any other recommendations for chemo constipation and diarrhea? Let me know in the comments below!
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Some other resources on the matter:
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