Palo Alto Medical Foundation
A Sutter Health Affiliate
Constipation is a common problem experienced by many patients and can be caused by chemotherapy, radiation, surgery, stress, or medications. Please do not be afraid or embarrassed to call your doctor or nurse at any time; if left untreated the constipation may get worse and not improve on its own. Many chemotherapy and anti-nausea medications cause constipation, so when starting chemotherapy take a stool softener like Ducosate every day unless otherwise directed. You must drink plenty of fluids when taking any laxatives for them to work effectively.
Over the counter medication management of constipation:
| To prevent constipation or to soften hard stools start: | If your stools are still hard after taking Colace for two days: | If your stools are still hard after increasing Colace for two days: |
| Take Colace® (generic name is Ducosate) stool softener 10Omg once in the evening. | Increase the Colace® to twice a day. | Continue taking the Colace® to twice a day.Add Senokot® (generic name is Senna) laxative 1-2 tablets in the evening. |
If you have not had a bowel movement in 2 or more days:
| On the first day of constipation: | If you have not had a bowel movement on the 2nd day: | If you have not had a bowel movement on the 3rd day: |
| Take 2 tablets Senokot® (generic name is Senna) 100mg twice a day | Continue taking 2 Senokot twice a day | Continue taking 2 Senokot and 2 tablespoons of Milk of Magnesia® twice a day |
| Increase your fluid intake to 8-10 glasses of water a day | Add 2 tablespoons of Milk of Magnesia® twice a day | Call your doctor’s office for further instructions. |
Dietary and lifestyle management of constipation:
- Smooth Move Tea®, available in many grocery stores, may also be very effective to relieve constipation. Instead of taking Senokot, drink one cup of this tea twice a day until you have a bowel movement. If you have not had a bowel movement by the 3rd day, call your doctor’s office for further instructions.
- FLUIDS: Drink 8-10 glasses of fluid a day. Avoid caffeine because it can cause dehydration which can cause or increase constipation.
- Drink a warm-to-hot decaffeinated drink about one half-hour before the usual time for a bowel movement.
- EXERCISE daily such as a half-hour walk, especially after meals.
- EAT: Small frequent meals and chew foods well.
- Eat dried or cooked prunes or drink prune juice 1-2 times a day.
- Increase your fiber intake. Do this only when you are able to drink plenty of fluids or increased fiber may increase constipation. Examples of high-fiber foods include whole-grain breads and cereals, whole wheat crackers and pasta, wheat bran & bran muffins, pinto beans, kidney beans and peas, fresh fruits and vegetables, oats, barley, brown rice and dried fruits like dried figs and prunes.
He knows everything about medications – to which pharmacological group the drug belongs, what components are included in its composition, how it differs from its analogs, what indications, contraindications, and side effects remedy has. John is a real pro in his field, so he knows all these subtleties and wants to tell you about them.