Constipation

• Small, hard, pellet-like bowel movements
• Stomach aches or cramps, frequent gas or belching
• Feeling bloated or swollen in your belly
• A sense of pressure in your rectum
• Going more than 3 days without a bowel movement
• Soft, liquid stool that leaks out unexpectedly

• Treatments–including chemotherapy, immunotherapy, or other targeted therapies 
• Medications and supplements, like:
  • Iron or calcium
  • Pain medications (morphine, oxycodone, fentanyl, etc.)
  • Antacids with calcium or aluminum
  • Anti-nausea medications (Zofran®, Aloxi®)
  • Certain antidepressants or sleep medications
• Diet and hydration, such as eating less fiber or drinking less fluids
• Lower activity levels, including after surgery or during treatment
• Tumor-related factors, like tumors pressing on the GI tract for people with metastatic breast cancer

If diet, fluid, and movement aren’t helping with constipation, your care team may suggest:

• Supplements
  • Benefiber®: Start with 1 dose daily, gradually increase to a max of 3 doses/day
  • Senna tea (e.g., Smooth Move®): Limit to 2 cups per 24 hours (short-term use only)
• Over-the-Counter & Prescription Medications for Constipation
• Medications to manage gas and bloating

Important: Always talk with your care team before starting laxatives.

If you’re taking opioid pain medications, constipation is likely. Here’s what helps:

• Start a stool softener the same day you begin pain meds
• Stick with your stool softeners while you’re on prescription pain medicine
• Keep drinking fluids, eating fiber, and moving when possible
• Call your care team if constipation persists

Yes—take extra care if your white blood cells are low:

• Avoid enemas or suppositories unless your care team says they’re safe

• Do not take mineral oil or other oil-based laxatives by mouth
• Avoid laxatives your care team hasn’t approved