Nutrition and daily life

Constipation: medicines, fluids and movement

Constipation is common during leukemia treatment. Opioid painkillers, anti-sickness drugs, chemotherapy such as vincristine, eating little, drinking little and moving little can all cause it. This section explains how to prevent it and when to ask for help.

Last updated: ~1 min read
Warm water and prune compote.
Figure 1.Fluids and compote — Constipation: medicines, fluids and movement

01Short answer

Drink enough unless your team has limited fluids. Choose fibre-containing but safe foods: cooked vegetables, oats, cooked fruit, prune compote. Walk as much as your strength allows. Laxatives are prescribed by your team; during neutropenia or low platelets do not use suppositories, enemas or rectal thermometers. Tell your team if you have had no bowel movement for more than 3 days, or have belly pain, bloating, vomiting or cannot pass wind.

02Simple explanation

Enough fluid.

Cooked fibre.

Movement.

No suppositories or enemas in neutropenia.

03Scientific explanation

NCI: opioids and vincristine slow the bowel; constipation is often prevented with medicines given in advance.

ESPEN: enough energy and protein matter for preventing weight and muscle loss in people with cancer, and nutritional status should be assessed regularly.

NCI: practical eating tips exist for treatment side effects such as nausea, taste changes and mouth sores.

04What happens in the body?

Fibre

Increase it gradually and with fluid; raw foods with skins follow food-safety rules.

Oat porridge and cooked vegetables.
Figure 2.Cooked fibre — Constipation: medicines, fluids and movement

Routine

A warm drink in the morning and time for the toilet after meals help.

An empty, bright hospital corridor.
Figure 3.A gentle walk — Constipation: medicines, fluids and movement

Dietitian

If you are losing weight, have no appetite or need a special diet, ask to see the hospital dietitian.

Food safety

Food-safety rules for neutropenia (see “Handwashing: the simplest protection” and “Eggs and dairy: safe choices”) apply at every stage.

05Nutrition: four steps

Assess, swap the risky, cook safely, eat regularly.

Assess — Weight and appetite.1AssessWeight and appetite.
Swap — A safe choice.2SwapA safe choice.
Cook — Hot throughout.3CookHot throughout.
Eat regularly — Small portions.4Eat regularlySmall portions.
StrengthEnergy.
ProteinFor muscle.
SafetyFood rules.

06Key points at a glance

TopicIn brief
FibreIncrease it gradually and with fluid; raw foods with skins follow food-safety rules.
RoutineA warm drink in the morning and time for the toilet after meals help.
DietitianIf you are losing weight, have no appetite or need a special diet, ask to see the hospital dietitian.
Food safetyFood-safety rules for neutropenia (see “Handwashing: the simplest protection” and “Eggs and dairy: safe choices”) apply at every stage.

07Key terms

Laxative
A medicine that softens stool or stimulates the bowel.
Opioid
A strong painkiller that can cause constipation.
Dietitian
A nutrition specialist.
Protein
A nutrient for repairing muscles and tissues.
Neutropenia
Low neutrophils.

08Key points

  • Fluid and cooked fibre.
  • Movement.
  • None for 3 days? Tell us.
  • A diet is not a treatment.
  • Talk to a dietitian.

09Frequently asked questions

Can I buy a laxative myself?

Ask your team; some do not suit your treatment.

Should I add bran?

Gradually and only with enough fluid; tell your team.

Can a special diet cure leukemia?

No. Good nutrition helps you cope with treatment, but it does not cure.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. Can I buy a laxative myself?

  2. Should I add bran?

  3. Can a special diet cure leukemia?

My questions

12Sources

  1. NCI. Constipation and Cancer Treatment
  2. National Cancer Institute. Eating Hints: Before, During, and After Cancer Treatment
  3. ESPEN. ESPEN practical guideline: Clinical Nutrition in cancer (2021)
  4. Leukemia & Lymphoma Society. Food and Nutrition
  5. World Health Organization. Healthy diet fact sheet
  6. National Center for Complementary and Integrative Health (NIH). Chamomile
  7. National Center for Complementary and Integrative Health (NIH). Peppermint Oil
  8. National Center for Complementary and Integrative Health (NIH). Cinnamon
  9. National Center for Complementary and Integrative Health (NIH). Sage
  10. Memorial Sloan Kettering Cancer Center — About Herbs. Nigella sativa
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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