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This area of gastrointestinal (GI) health is expanding rapidly. Some of the newest drugs are able to block opioid action in the bowel and prevent constipation while allowing the opioid to relieve pain in the rest of the body. This section describes the latest findings for treating constipation when cancer is present.

Most Helpful

Many places in your body have receptors for various chemicals, including opioids. When opioids bind to those receptors, you experience pain relief. A drug called naloxone selectively binds to opioid receptor sites in the intestine-which means that the intestines won't experience the slow-down in movement that opioids normally cause-but pain relief action in the rest of the body will still occur.

Methylnaltrexone was approved by the FDA to help restore bowel function in patients with late-stage, advanced illness, including cancer, who are receiving opioids on a continuous basis to help alleviate pain.

Likely to Be Helpful

A known way to combat constipation in patients with cancer is to treat it before it happens. Your physician may prescribe a prophylactic regimen of a certain type of laxative, plus a stool softener.

If you are taking an opioid medication, sometimes changing that medication to methadone or a transdermal fentanyl patch can reduce or eliminate the need for laxatives. Different opioids vary in how markedly they affect the intestines, so rotating opioid medications can help minimize constipation. However, your healthcare provider will decide which pain medication is most appropriate for your condition.

If constipation has been a problem for a long time and previous treatments have not alleviated it, your physician may prescribe polyethylene glycol, known as PEG, to help bowel action.

Not Enough Evidence

This category includes many types of prescription and over-the-counter laxatives: bulk laxatives, osmotic laxatives, and stool softeners. It also includes enemas.

The laxative that works best for you depends on many variables, including

  • Your current condition
  • The medications you are taking
  • Your bowel symptoms
  • The location and type(s) of tumors you have.

Despite how you may feel about discussing constipation with your oncology nurse or physician, the best advice we can give you is, "Do it!" He or she is uniquely trained to help you achieve the best results that will work with your treatments and other medications.

 

Prophylactic

preventive

 
 

Opioid

a natural or synthetic opium derivative; opioids are a type of pain killer that works on the central nervous system.

 
 

Methadone

a long-acting synthetic opioid that’s used for treating pain

 
 

Fentanyl

an analgesic. A patch with fentanyl on it delivers the pain killer through the skin in a time-release manner.

 
 

Bulk laxatives

increase water retention in the stool

 
 

Osmotic laxatives

pull water into the intestine from surrounding tissues

 
 

Stool softeners

allow water and fats to penetrate the stool so that it is not dry or hard

 
 

Enemas

the process of introducing liquid into the rectum and colon. The increasing volume of the liquid causes stretching of the lower intestinal tract. This causes cramping and peristalsis that empties the lower intestinal tract.