Pediatric Concerns

Children with cancer can pose special treatment challenges, and the same is true for treating their symptoms of constipation.

Because younger children may not have well-established bowel habits, general measures that can be taken include

• Providing a comfortable, quiet environment
• Avoiding the use of a bedpan when possible
• Minimizing the use of constipating medications whenever possible (ask your oncology nurse or physician about this)
• Developing a regular bowel regimen
• Providing a balanced diet with enough fruits and vegetables.

Opioid-induced constipation can be treated with a combination of laxative plus stool softener, but be sure to consult your oncology nurse or physician because

• Many laxatives are on the market.
• Laxatives work in different ways.
• Some are better suited to your child's needs than others-based on your child's symptoms and age.

If you suspect that your child has stool blocking the bowel that he or she cannot pass, contact your physician immediately. Treatment depends on where the impaction is located (high or low in the colon).

"Home remedies" to avoid include

• Corn syrup
• Enemas (except as directed by your doctor)
• Castor oil.

In addition, avoid

• Stimulant laxatives
• Dietary fiber in amounts greater than that recommended for a healthy child.

No studies have been conducted on using polyethylene glycol (PEG 3350) in children with cancer, but PEG 3350 has been used effectively in relieving constipation in children with constipation for other reasons. This type of laxative pulls water into the intestine from surrounding tissues, which helps bowel action.

Rely on your oncology nurse and physician for advice. Don't minimize your child's discomfort, and don't wait several days before contacting a healthcare professional for help. Constipation is not a minor issue, and a variety of helpful treatments are available. Your oncology healthcare professionals will know the right ones for your child.