Constipation is the slow movement of feces (stool or body wastes) through the large intestine resulting in infrequent bowel movements and the passage of dry, hard stools. The longer it takes for the stool to move through the large intestine, the more fluid is absorbed and the drier and harder the stool becomes.

Inactivity, immobility, or physical and social barriers (for example, bathrooms being unavailable or inconveniently located) can make constipation worse. Depression and anxiety caused by cancer treatment or cancer pain can also lead to constipation. The most common causes of constipation are not drinking enough fluids and taking pain medications.

Constipation is annoying and uncomfortable, but fecal impaction (a collection of dry, hard stool in the colon or rectum) can be life-threatening. Patients with a fecal impaction may not have gastrointestinal symptoms. Instead, they may have circulation, heart, or breathing problems. If fecal impaction is not recognized, the signs and symptoms will get worse and the patient could die.

A bowel obstruction is a partial or complete blockage of the small or large intestine by a process other than fecal impaction. Bowel obstructions are classified by the type of obstruction, how the obstruction occurred, and where it is. Tumors growing inside or outside the bowel, and scar tissue that develops after surgery, can affect bowel function and cause a partial or complete obstruction. Patients who have colostomies are especially at risk of developing constipation, which can lead to bowel obstruction.

Diarrhea can occur at any time during cancer treatment. Although diarrhea occurs less often than constipation, it can be physically and emotionally devastating for patients who have cancer. Diarrhea can cause:

• Changes in eating patterns.
• A loss of body fluids.
• Chemical imbalances in the blood.
• Impairments in physical function.
• Excessive tiredness.
• Skin problems.
• A decrease in physical activity.
• Problems that can be life-threatening in some patients.

Diarrhea is an abnormal increase in the amount of fluid in the stool that lasts more than 4 days but less than 2 weeks. It may also be described as an abnormal increase in the amount of fluid in the stool and the passage of more than 3 unformed stools during a 24-hour period. Diarrhea is considered a long-term problem when it lasts longer than 2 months.

Radiation enteritis is a condition in which the lining of the bowel becomes swollen and inflamed during or after radiation therapy to the abdomen, pelvis, or rectum. The large and small bowels are very sensitive to radiation. The larger the dose of radiation, the greater the damage to normal bowel tissue. Most tumors in the abdomen and pelvis need large doses, and almost all patients receiving radiation to the abdomen, pelvis, or rectum will show signs of acute enteritis.

Acute symptoms are those that appear during the first course of radiation therapy and up to 8 weeks later. Chronic radiation enteritis may appear months to years after radiation therapy is completed, or it may begin as acute enteritis and continue after treatment stops. Only 5% to 15% of persons treated with radiation to the abdomen will develop chronic problems. Several factors affect how long the enteritis will last and how severe it will be:

• The dose of radiation given.
• The tumor size and how much it has spread.
• The amount of normal bowel treated.
• Whether chemotherapy was given at the same time as the radiation therapy.
• Whether radiation implants were used.
• Whether the patient has high blood pressure, diabetes, pelvic inflammatory disease, or poor nutrition, or has had surgery to the abdomen or pelvis. These conditions can decrease blood flow to the bowel wall and affect bowel movement, increasing the chance of radiation injury.

Glossary Terms

The area of the body that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.

Not normal. An abnormal lesion or growth may be cancerous, premalignant (likely to become cancer), or benign.

Symptoms or signs that begin and worsen quickly; not chronic.

Feelings of fear, dread, and uneasiness that may occur as a reaction to stress. A person with anxiety may sweat, feel restless and tense, and have a rapid heart beat. Extreme anxiety that happens often over time may be a sign of an anxiety disorder.

A tissue with red blood cells, white blood cells, platelets, and other substances suspended in fluid called plasma. Blood takes oxygen and nutrients to the tissues, and carries away wastes.

The long, tube-shaped organ in the abdomen that completes the process of digestion. The bowel has two parts, the small bowel and the large bowel. Also called the intestine.

A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord.

Treatment with drugs that kill cancer cells.

A disease or condition that persists or progresses over a long period of time.

The longest part of the large intestine, which is a tube-like organ connected to the small intestine at one end and the anus at the other. The colon removes water and some nutrients and electrolytes from partially digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus.

An opening into the colon from the outside of the body. A colostomy provides a new path for waste material to leave the body after part of the colon has been removed.

A condition in which stool becomes hard, dry, and difficult to pass, and bowel movements don’t happen very often. Other symptoms may include painful bowel movements, and feeling bloated, uncomfortable, and sluggish.

A mental condition marked by ongoing feelings of sadness, despair, loss of energy, and difficulty dealing with normal daily life. Other symptoms of depression include feelings of worthlessness and hopelessness, loss of pleasure in activities, changes in eating or sleeping habits, and thoughts of death or suicide. Depression can affect anyone, and can be successfully treated. Depression affects 15-25% of cancer patients.

A disease in which the body does not properly control the amount of sugar in the blood. As a result, the level of sugar in the blood is too high. This disease occurs when the body does not produce enough insulin or does not use it properly.

Frequent and watery bowel movements.

The amount of medicine taken, or radiation given, at one time.

Liquid.

GI. Refers to the stomach and intestines. Also called GI.

A blood pressure of 140/90 or higher. Hypertension usually has no symptoms. It can harm the arteries and cause an increase in the risk of stroke, heart attack, kidney failure, and blindness. Also called high blood pressure.

A type of radiation therapy in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near a tumor. Also called brachytherapy, radiation brachytherapy, and internal radiation therapy.

Redness, swelling, pain, and/or a feeling of heat in an area of the body. This is a protective reaction to injury, disease, or irritation of the tissues.

Having to do with inflammation (redness, swelling, pain, and a feeling of heat that helps protect tissues affected by injury or disease).

The long, tube-like organ that is connected to the small intestine at one end and the anus at the other. The large intestine has four parts: cecum, colon, rectum, and anal canal. Partly digested food moves through the cecum into the colon, where water and some nutrients and electrolytes are removed. The remaining material, solid waste called stool, moves through the colon, is stored in the rectum, and leaves the body through the anal canal and anus.

The taking in and use of food and other nourishing material by the body. Nutrition is a 3-part process. First, food or drink is consumed. Second, the body breaks down the food or drink into nutrients. Third, the nutrients travel through the bloodstream to different parts of the body where they are used as "fuel" and for many other purposes. To give the body proper nutrition, a person has to eat and drink enough of the foods that contain key nutrients.

Blockage of a passageway.

The lower part of the abdomen, located between the hip bones.

Inflammation of the small intestine caused by radiation therapy to the abdomen, pelvis, or rectum. Symptoms include nausea, vomiting, abdominal pain and cramping, frequent bowel movements, watery or bloody diarrhea, fatty stools, and weight loss. Some of these symptoms may continue for a long time.

The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called radiotherapy and irradiation.

The last several inches of the large intestine closest to the anus.

The part of the digestive tract that is located between the stomach and the large intestine.

The material in a bowel movement. Stool is made up of food that was not digested, bacteria, mucus, and cells from the intestines. Also called feces.

A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.

An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.

A group or layer of cells that work together to perform a specific function.

An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancerous), or malignant (cancerous). Also called neoplasm.