Bowel habits

Bowel problems are a common problem during cancer and its treatments.  The main problems you may be aware of are constipation or diarrhoea - when your bowel habits change, the symptoms can be uncomfortable. Other symptoms of bowel problems include pain, bowel cramps, bloating and loss of appetite.

Chemotherapy, radiotherapy and surgery can temporarily change your bowel function. Medications, inactivity and a change in food intake can add to this problem, infections can also lead to diarrhoea. Normal bowel movements vary from person to person, so it is what is normal for you which counts. 

Constipation is when it is difficult to empty your bowels and the stools are dry and hard. You may feel bloated and uncomfortable and find trying to pass your stools painful. 

Managing constipation

Constipation is uncomfortable, and it can build up gradually.  Your healthcare team will explain if this symptom is expected, and there are steps you can take to help prevent and manage the problem:

• Take stool softeners and/or laxatives as recommended by your healthcare team. 
• Drink plenty of fluids, up to 8 glasses of water a day to help keep the stools soft and maintain a normal bowel habit. 
• Try some light exercise as this will help keep the bowel working smoothly.
• Eating a high fibre diet can help, e.g. whole wheat breakfast cereals, wholemeal bread, pasta, brown rice, fruit and vegetables with skins on.  However, check with your healthcare team if this will be ok,for some cancers, and treatments which affect the bowel, a high fibre diet isn’t recommended.
• Eating at the same time of the day and regular meals can help restore a normal bowel habit.
• Taking time to go to the toilet and not straining, or rushing, can help too.  

If the symptoms persist, tell your doctor, as constipation can cause complications. The bowel may become impacted (blocked by hard stool) and cause further problems.

Diarrhoea is when the stools become loose and watery and you may find you’re passing stools frequently. More than three times a day can be classed as diarrhoea, it is often accompanied with cramps, wind and discomfort. If you are aware of a change to your normal bowel habits, do discuss your concerns with your doctor and hospital team. It helps to sort the symptoms out early and to try and prevent the problems in the first place. (If you have an ileostomy or stoma you may need specific advice). 

Managing diarrhoea

Diarrhoea can feel more distressing than constipation sometimes. The urge to go to the toilet immediately adding to the general upset of the diarrhoea symptoms themselves. Your healthcare team will have explained that diarrhoea may happen with some of your cancer treatments.

Sometimes diarrhoea is a mild and temporary side effect, it is a symptom that shouldn’t be ignored as you could soon become dehydrated (dry) and this can cause lead to further problems.

• Ask for, and take any medication to help ease the diarrhoea, as prescribed by your doctor. You may also be given some tablets to relieve the pain and cramps if they’re very uncomfortable.
• Try and drink plenty of fluids, ideally 8 glasses of water a day, as this will help keep you hydrated.
• Eat light meals only, avoiding high fibre foods , greasy foods, caffeine and dairy foods. 
• Try and eat small amounts little and often, rather than a big meal. Foods which might help bulk up the stool include rice, pasta, skinless potatoes, white bread, bananas, chicken and fish.

If your temperature is higher than normal, you pass blood or tarry stools, or the diarrhoea is becoming more frequent (4-6 times a day or more), then let your doctor/healthcare team know immediately.