SUMMARY
Constipation is a common result of advanced disease and drug therapy. It occurs in as many as 50% of advanced cancer patients and 85% of patients taking high dose opioids. Potential causes are described. Prevention and early reversal are important. Nondrug and pharmacological methods of preventing and treating constipation are described. Evaluation instruments that have been used for this symptom are described. Some open research questions are listed. A management algorithm, evidence tables, and drug therapy tables which include drug costs are presented.
KEYWORDS:
- Constipation
- bowels
- impaction
- palliative care
- terminal care
- dying
- opioids
- prevention
- supportive care
- drug therapy
- non-pharmacological therapy
- etiology
- evidence
- costs
- algorithm
- senna
- casanthranol
- bisacodyl
- sorbitol
- lactulose
- milk of magnesia
- sodium phosphate
- sodium biphosphate
- enemas
- minienemas
- naloxone
- manual evacuation
- docusate
- glycerin
- abdominal
- flatulence
- bloating
- malaise
- nausea
- systematic review