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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)

(Life - threatening) Grade 5 Occasional or intermittent symptoms; occasional use of stool softeners, laxatives, dietary modification, or enema Persistent symptoms with regular use of laxatives or enemas; limiting instrumental ADLs Obstipation with manual evacuation indicated; limiting self care ADL Life-threatening consequences;

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