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Symptom Management Guidelines: CONSTIPATION

Symptom Management Guidelines: CONSTIPATION Definition(s) CONSTIPATION : A subjective experience of an unsatisfactory defecation characterized by infrequent stools and/or difficult stool passage ( straining, incomplete evacuation, hard/lumpy stools, prolonged time to pass stool, need for manual maneuvers) Contributing Factors Chemotherapy Agents Vinca alkaloids ( vincristine, vinblastine, vinorelbine) Platinums ( carboplatin, oxaliplatin) Taxanes ( paclitaxel) Thalidomide Medications Opioids Vitamin Supplements ( calcium and iron) Antiemetics ( 5-HT3 antagonists- ondansetron, granisetron) Drugs with anticholinergic effects ( antidepressants, antihistamines, antiparkinsonisms) Antispasmodics, anticonvulsants, phenothiazines Antacids that contain aluminum and calcium Diuretics Relevant Medical History Metabolic disturbances - Electrolyte imbalances ( hypercalemia, hyponatremia, hypokalemia) - Hypothyroidism - Uremia - Diabetes Neurological disturbances - Spinal cord involvement ( compression and injuries) - Sacral nerve infiltration - Autonomic dysfunction Structural Abnormalities - Narrowing of bowel lumen-tumor compression, radiation fibrosis/scarring, sur

bowel obstruction - Sensory loss, +/- motor weakness, urinary changes such as incontinence or ... absorption in the small and large intestine Is easier to prevent than treat. Initiation of a prophylactic bowel protocol is recommended for patients regularly taking ... - Low fiber food choices for partial bowel obstruction Bowel Protocols ...

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