TIPS FOR MANAGING CONSTIPATION

Constipation is a common side effect of many medications, particularly narcotic pain medications. Not having a bowel movement for two days while you are using narcotic pain medications qualifies as constipation.

Most people will need to take a laxative and/or stool softener during the time they are taking pain medication, but check with your physician or nurse before taking laxatives/stool softeners. Also, to help relieve constipation, add high fiber foods to your diet. These include raw fruits and vegetables, whole grain breads, bran cereals, dried fruits (especially prunes), and fruit juices. Some people find drinking prune juice or hot lemon water before bedtime, or first thing in the morning to be effective for constipation.

Remember:

• Drink 8-10 cups of non-caffeinated, non-alcoholic fluid every day. Water is the most important fluid to drink. This helps to keep the stool soft.
• As you are able, exercise some every day.
• Set a regular time for a daily bowel movement when you are not rushed and can have privacy.
• If at any time you feel the urge to move your bowels, do not ignore it.

Laxatives:

A laxative with senna, such as Senakot-S, is a good choice. We recommend this schedule:
Use Senokot-S or other similar laxative with senna (ask your pharmacist). Take two tablets every night at bedtime.

• If you do not have a bowel movement for two days, do the following:
• Take two more Senokot-S tablets at noon.
• If no bowel movement by bedtime, take two tablespoons of Milk of Magnesia before going to bed.
• If no bowel movement the next morning, use one Dulcolax suppository*.
• If no results after using the suppository, call the physician’s office and discuss with the nurse.
• *Do not use suppository if your white count or platelet count is low due to chemotherapy or radiation therapy. If you are unsure, call and talk with your nurse.

Once constipation is resolved with the measures described above, a regimen of laxatives can help prevent constipation from recurring.

Use the following guidelines to adjust your daily dose of Senakot-S:

Do not use more than eight tablets a day. Call and talk with your nurse if eight tablets are not working for you.

• If you develop diarrhea, you should hold laxatives for one day, and then resume regular schedule. Call and discuss with your nurse if needed.
• Always let your physician or nurse know if constipation is not being controlled by dietary changes and/or medication.
• It is important not to take effersylium products, such as Metamucil, unless you are able to drink eight or more glasses of fluid per day. It usually adds too much bulk and, with a slower moving bowel, it creates more problems with constipation.

IF YOU HAVE ANY QUESTIONS REGARDING THE TOPICS DISCUSSED, PLEASE ASK YOUR PHYSICIAN OR NURSE.