Study finds chemo constipation impacts one in five
Nearly one in four cancer patients receiving chemotherapy develop constipation, a 2024 systematic review in Cancers reported. The review combined data from 54 studies with over 33,000 patients and identified an average rate of 22%, though individual studies showed rates between 0.8% and 86.6%.
Sarah Friend, a breast medical oncologist at City of Hope Cancer Center Atlanta, stated that constipation is usually manageable when addressed early.
How chemotherapy affects digestion
The issue often comes from medications given with chemotherapy rather than the treatment itself. Amar Rewari, chief of radiation oncology at Luminis Health and adjunct assistant professor at Johns Hopkins School of Medicine, explained that anti-nausea drugs and pain relievers are the most common culprits.
Opioids slow intestinal movement. Reduced physical activity, dehydration, and decreased food intake during treatment also contribute. Rewari noted that multiple factors typically occur together.
Some anti-nausea medications, including 5-HT3 receptor antagonists like ondansetron, can make the problem worse. Friend added that patients should tell their oncology team about any bowel habit changes right away since several factors often overlap.
Lifestyle changes may help, but caution is necessary
Small adjustments can prevent constipation from getting worse. Drinking enough water, staying active when possible, and eating high-fiber foods help. Patients with bowel obstructions or other gastrointestinal conditions should check with their care team before increasing fiber.
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Over-the-counter constipation medications are usually safe but require a cancer specialist’s approval. Daniel Landau, medical director of virtual hematology at the Medical University of South Carolina, listed common options like stool softeners, osmotic laxatives, and stimulant laxatives.
For those taking opioids or chemotherapy drugs that slow digestion, Landau suggested starting a preventive bowel regimen before symptoms become severe.
Signs that require immediate medical care
Most constipation during chemotherapy is uncomfortable but not life-threatening. However, some symptoms need urgent evaluation. According to the source, patients should contact their oncology team if they experience:
- Severe abdominal pain or vomiting
- Significant bloating or swelling
Friend emphasized that patients shouldn’t feel embarrassed. “Your team has heard this before and wants to help,” she said.
Managing these side effects is part of a broader challenge for patients dealing with complex medical histories.
