Bowel Management in Patients with Cancer

Chapter Overview

This chapter addresses concepts used as a foundation for bowel management in patients with cancer. Because cancer treatment can be very noxious and disrupt bowel function, a preventive approach is an important part of bowel management for patients with cancer. The 6 steps to good bowel management are assessment and diagnosis of bowel dysfunction, normalization of the bowel, establishment of expectations for bowel-movement frequency, development of a bowel management program, assessment of outcomes, and adjustment of the bowel management program through problem-solving. New and innovative approaches to management of bowel dysfunction covered in this chapter are (1) differentiation between low and high impactions in the treatment of impactions; (2) administration of milk-and-molasses enemas; (3) use of a bowel training program for patients with constipation or diarrhea or frequent stooling; and (4) use of a proven, nontraditional fiber regimen for patients with frequent stooling after colorectal surgery. Opiate-induced constipation may be effectively prevented using senna and docusate sodium. Gastrointestinal gas may be decreased through controlling the intake of certain foods. Diarrhea in patients with cancer may have various noncancer causes, including impaction, lactose intolerance, food allergies, and medication. The cause of diarrhea, not the symptom, must be treated for optimal relief.