I get some very interesting questions sometimes as a breast cancer coach and today one of my clients asked a very good question: “Why does chemo cause constipation?”
Being the naturally inquisitive sort, I looked into this when I was going through chemotherapy, I wondered the same thing. I could understand the digestive changes because chemotherapy drugs are targeting all of the rapidly growing and dividing cells, which is one of the reasons our mouths and digestive tracts and even hair suffer the effects of certain chemo drugs – they are lined with rapidly dividing, quick growing cells.
Certain Chemotherapy Drugs Cause Constipation Because…
For one thing, a certain class of chemotherapy drugs called vinca alkaloids affect the nerve supply to the gut. Vinca alkaloids are a class of cell cycle-specific specific drugs that work by reducing the ability of cancer cells to divide. These compounds include vinblastine, vincristine, vindesine and vinorelbine. If you want to know more about how these drugs work, just look them up on Wikipedia, there is a lot of really interesting information about them there.
To complicate matters, some of the painkilling drugs (especially morphine based drugs) and anti-nausea meds that are prescribed just make the constipation problem worse.
Some Helpful Suggestions for Chemo Induced Constipation
Eat foods high in fiber like whole grains, vegetables and some fruits (see my compote recipe below);
Drink plenty of filtered water and freshly prepared juices each day (some doctors will rule against fresh fruit and vegetables for certain kinds of cancer treatments);
Exercise for 20-30 minutes – things like yoga, tai chi and walking are highly recommended;
See my article Natural Remedies for Chemo-Related Constipation for the recipe for one very effective herbal remedy you can either make yourself or have a naturopath mix up for you (scroll down the page for that recipe, it’s toward the bottom under Constipation Herbal). See also the great recipe for Prune, Fig & Raisin Tea on that page.
Date, Apple, Prune & Apricot Compote Recipe
I used this recipe and found it absolutely delicious and very helpful for chemo induced constipation. You need 2 organic apples, about 10 organic prunes (pitted), 3 organic dates, 5 organic apricots and about 1/2 cup filtered water. Wash the apples and cut them into wedges, leaving the skin on (removing the seeds). Place the wedges in a saucepan with water, prunes, dates and apricots. Cover with a lid and place over medium heat. Bring to a boil and simmer for around 3-4 minutes, remove the lid and stir the fruit up. Cook the fruits just until soft and serve warm. Sprinkle with freshly ground flaxseed or soaked chia seeds.
When to Seek Medical Help for Constipation
If you are constipated for more than 3 days, tell your doctor or nurse. If you are having sharp abdominal pains, a fever, an inability to pass gas, nausea and vomiting (which admittedly can be caused by the chemotherapy drugs themselves but if it seems to be related to your constipation), or your stomach is distended and feels hard to the touch, get in to see your doctor right away.
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Going through chemotherapy and having constipation is NOT fun. I mean, it’s not bad enough that you’re going through chemotherapy, you’ve lost your hair, now you gotta have this problem too? I can SO sympathize with you.
Just so we’re clear, you are considered to be constipated if you have fewer than three difficult bowel movements in a week. Which is not much!
My oncologist gave me a couple of recommendations but I wasn’t crazy about them – they were all pharmaceuticals and I prefer to use the things that nature has provided us (which is why it took me four months to make my decision about doing chemotherapy!).
So I searched further afield (let’s face it, I was motivated!) and found some more natural things to help. When I had my next office visit with him, he asked how I was doing with the constipation and I told him I had a good herbal formula that was working for me he exasperatedly said to me (laughing) “Do you listen to anything I tell you?” I guess he wasn’t used to having patients do things their own way.
My List of Recommendations for Constipation
Eat foods high in fiber like nuts, bran, vegetables, legumes, freshly ground flaxseed, whole wheat breads and pastas, and fruits
Drink 2-3 liters of non-alcoholic fluids (water, juices) each day, unless you are told otherwise by your doctor
Avoid sodas, coffee, alcohol and caffeine-containing drinks, which can have a diuretic effect and worsen constipation
Exercise 20-30 minutes most days of the week, as tolerated, and if okay with your doctor. A lot of patients find that walking for exercise is convenient and easy to do
Take 2 tsp of freshly-ground flaxseed two-three times per day
Try drinking a glass of lukewarm or hot water just after you wake up. The warmth helps stimulate your intestines so that they start moving
Try my herbal formula (recipe below)
If you hate the herbal (and some will), try the Prune, Fig & Raisin tea recipe below
My naturopath in Perth, Sue Bartoll, made a herbal formula for me and she’s been kind enough to share the recipe. You will still probably want or need a naturopath or herbalist to blend this for you. You may have to convert milliliters to ounces but most measuring devices have both these days.
40 ml Senna
30 ml Golden Seal
40 ml Fennel
50 ml Butternut
5 ml Ginger
40 ml Liquorice
Dosage 5mls 2 x day with water or juice. Start with 2.5mls twice a day and increase over the next 2 days to full dosage. Sue says: “Please note that everyone is individual and may require another prescription that is appropriate for the person’s symptoms.”
Prune, Fig & Raisin Tea
Cut up about 12 organic figs and place them in a saucepan together with about 12 organic prunes and 2 tbsp organic raisins. Cover with 1 liter (4 cups) of filtered water and simmer for about 30 minutes. If desired, lemon juice may be added to vary the flavor. Drink the tea before breakfast and dinner time. You can make this ahead the night before and refrigerate.
Why Constipation Occurs with Chemotherapy
Because anticancer drugs are made to kill rapidly growing cells, they also affect normal, fast-growing cells such as blood cells forming in the bone marrow and cells in the digestive tract (i.e., mouth, stomach, intestines, esophagus), reproductive system, and hair follicles. Some anticancer drugs may affect cells of vital organs, such as the heart, kidney, bladder, lungs, and nervous system.
The anti-nausea drugs and steroids used during chemotherapy can also cause constipation. It may take a few days after your infusion before your bowels return to normal. Diarrhea can also occur as the microflora in the bowel is destroyed by the chemo drugs.
I noticed that “things” just seemed to grind to a halt the day after my infusions, which was very uncomfortable. Once I started taking the above herbal though, it helped me a lot. I found it helped for me to take the herbal the day before an infusion and then to continue it until things normalized, usually 2-4 days later.
If These Occur, See Your Doctor Right Away
Sometimes, chemo-related constipation can get out of hand. If you get any of these symptoms, see your doctor right away:
Pain in your stomach
Unable to pass gas
Nausea, and/or vomiting along with your constipation
If you have not had a bowel movement in three days despite following the above recommendations
If your stomach looks swollen and/or feels hard to the touch
“Better Health Through Natural Healing” by Ross Trattler, Harper Collins Publishers
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About Marnie Clark
Hi I'm Marnie Clark, breast cancer survivor, and breast cancer coach. I have 20+ years of experience in natural medicine. In 2004/05 I battled breast cancer myself. You can see more about my journey on my page Breast Cancer Diary.
I've been healthy and recurrence-free since 2004 and in 2012 I became a Breast Cancer Coach because I became aware of the fact that whilst there is now a wealth of information on the Internet, much of it is confusing, conflicting, and sometimes just wrong!
Why should you work with me? Because:
(1) You don't want to go through this journey alone, feeling unempowered, frightened or just plain
clueless about what to do to help yourself.
(2) You will have someone working tirelessly on your behalf, putting together a healing plan for
you so you don’t have to lose your precious energy researching what food you should eat,
what supplements you should take, and what other things you can do that will give you the
best chances for survival. Instead you can spend that time resting, meditating, healing.
(3) You will learn what questions to ask your doctor (and have someone to turn to for the
questions they can't or won't answer).
(4) You will be armed with the tools and strategies you will need to get through the therapies you
choose so you can make your body hostile terrain for cancer.
You can also “like” me on Facebook (Marnie Clark, Breast Health Coach) to get my inspirational snippets, news and updates. I promise to do my utmost to keep you informed and empowered on your healing journey… and beyond.