Constipation in cancer patients

Abstract

The prevalence of constipation varies widely due to non-reporting or because this information is not captured during visits to hospital or outpatient clinics; however, it has been estimated to be in a range of 0.7 % to 79 % (median 16 %) in the worldwide general population (Mugie et al. Best Pract Res Clin Gastroenterol 25(1):3-18, 2011). Mugie and colleagues state that the difference can be attributed to other factors including socioeconomic, cultural, dietary, and environmental. There have been challenges to the way we practice medicine as a result of healthcare reform occurring in the United States and worldwide. Patients’ involvement in their care, and preventive care, is widely emphasized, as well as conscious use of limited resources. Visits to the emergency department (ED) and hospital admissions for constipation are considered avoidable if recognition of the risk factors and education are initiated proactively (Delgado-Guay et al. J Pain Symptom Manage 49(3):497-504, 2015). Constipation is a common complaint in the ED. In this chapter, we will evaluate and discuss the factors associated with constipation in cancer patients, together with clinical manifestations, diagnoses, mechanism, and pathophysiology. We will also discuss when constipation constitutes an emergency, its treatment, prevention, and patient education.