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Constipation

What Is Constipation?

Constipation is a condition where stool (poop) is hard, difficult to pass, or moves too slowly through the digestive tract. Constipation is a common side effect of certain treatments for serious childhood illnesses such as cancers and blood disorders.

Dietary changes, drinking more fluids, and physical activity can help manage constipation. Your child’s care team may also recommend medicines to help.

Diagnosis of constipation

Bowel habits are different for everyone. But usually your child should have bowel movements 3 or more times a week.

Constipation symptoms include:

  • 2 or fewer bowel movements per week
  • Hard, dry, lumpy, stool
  • Stool that is larger than normal or is in small pieces
  • Pain or straining to pass stool
  • Stomach cramps and pain
  • Gas, bloating, swollen belly
  • Feeling of having to go after a bowel movement
  • Nausea and vomiting

Your child might need a medical exam to confirm constipation. The exam may include a health history, feeling the abdomen, lab tests, or imaging tests.

Medical illustration of the digestive system

Bowel habits are different for everyone. But usually your child should have bowel movements 3 or more times a week.

Causes of constipation

Several factors may lead to constipation in children with serious illnesses.

  • Low fiber diets
  • Decrease in food intake
  • Low fluid intake or dehydration
  • Physical inactivity
  • Pressure on stomach or intestines due to the tumor
  • Other medical conditions such as diabetes, hypothyroidism, or celiac disease

Medicines that can cause constipation

Constipation is a side effect of some common medicines.

  • Pain medicines like opioids and NSAIDS
  • Anti-nausea medicines
  • Antacids
  • Diuretics
  • Allergy medicines including antihistamines
  • Antidepressant medication
  • Iron supplements
  • Some chemotherapy drugs such as vincristine and vinblastine

Some common medicines are codeine, fentanyl, hydrocodone, methadone, morphine, and oxycodone.

Opioid medicines can:

  • Slow the movement of the intestines
  • Decrease fluid in the intestines
  • Decrease muscle tone and weakening reflexes that control the elimination of stool

Your child’s care team may recommend a laxative if your child is prescribed an opioid.  

Treatment for constipation

Mild constipation is usually first treated with diet and lifestyle changes like drinking more water, eating more fiber, and increasing physical activity.

The next step in treatment may be medicine to encourage bowel movement.

Medicines for constipation

Laxatives are medicines that relieve constipation. Your child may take them by mouth. But your child’s doctor could also prescribe an enema or rectal suppository.

Many laxatives are available without a prescription. Talk with the care team before giving your child any medicine.

Diet changes to help constipation

Nausea, loss of appetite, and fatigue can make it hard for patients to eat enough calories and high fiber foods during cancer treatment. Some diet changes to help constipation include:

  • Eat foods high in fiber. These include fruits, vegetables, whole grains, beans, and nuts.
  • Drink plenty of fluids.
  • Eat regular meals.
  • Have a warm beverage or warm oatmeal for breakfast.

Find more nutrition tips to help with side effects.

Cool disabled teenager in wheelchair having cereal for breakfast and reading book at home.

Eating foods high in fiber can help combat constipation.

Complications of constipation

  1. Fecal Impaction of the Colon

    Severe constipation may lead to fecal impaction. When this occurs, stool hardens into a dry mass that becomes stuck in the rectum.

    Treatments include enema or manual stool removal.

  2. Ileus

    An ileus occurs when the intestines become blocked due to a lack of normal intestinal movement.

    Treatment includes:

    • Fluids
    • IV fluids
    • Avoiding medicines that cause constipation
    • Gastrointestinal decompression to relieve pressure and vomiting. This is often done using a nasogastric (NG) tube placed through the nose and into the stomach.

  3. Care for Rectal and Anal Pain

    Any cut, break, or tear in the skin in the anal area could lead to infection. Let the care team know about any skin problems.

    Some ways to prevent and treat these problems include:

    • Avoid straining and limit time on the toilet.
    • Wipe the area gently but thoroughly. It may help to use moist toilet paper or unscented bathroom wipes.
    • Take a warm bath.
    • Apply a cream as recommended by your child’s care team.

    If you have questions or concerns, talk with your child’s care team.

Key Points

  • Constipation can be a common side effect of treating serious childhood illnesses such as cancer and blood disorders.
  • Parents can help by talking with the care team, offering their child high-fiber foods, and following treatment plans.
  • Parents should let the care team know if they have concerns about constipation.
  • Untreated constipation can cause more serious problems like a fecal impaction.

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Together does not endorse any branded product mentioned in this article.

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Reviewed: April 2022

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