Severe constipation after chemo

For me, the constipation from carboplatin/ paclitaxel went away on its own after about a week. My stomach also felt better at about the same time. Taking Miralax didn't speed things up for me. It just made things messier when it eventually resolved on its own. So I stopped worrying about it and just waited.

@val64
Thanks for the info. I tried miralax and it did nothing. I guess I just need to be more patient.

Hi Mary-
Constipation is the worst for me, also. I had it during frontline and also now while I am on Elahere. There are many tricks, but some work for some and some work for others. I am taking Miralax once per day (AM) senna at night and even use smooth move tea. Sometimes even that provides no relief. I also think personally, figs and dates can help (Soak figs in hot water, drink the water and eat the soft figs). I also think kiwi helps. And water, water, water. I would say talk to your doctor. Being patient can often mean you are miserable, and that is no good. Also, compazine is less constipating than zofran, so if you have nausea, try that? Best of luck to you, teal sister.

Water and moving/walking.
My constipation after treatment got worse. I started to eat oatmeal with fruit and nuts every morning which helps. I’ve used Citrucel when desperate but I really try to manage this with diet. Good luck!

Yes! It was severe with me. I used the stool treatment they suggested and it did help, but if you wait thinking it won’t happen this time…it happens again.

Forgive me, I just want to help, and I know this is gross, but it helped me. Take a small soft plastic smooth coated baby spoon, apply Vaseline all over the spoon, at the opening of your rectum when it is impacted…little by little, and carefully, dig out the hardened stools, into the toilet.
When the blockage is reduced, your body can handle the rest.
I had to do this s cereal times.

I feel you! I have had chronic, severe constipation since my hysterectomy. Miralax (nor senokot) has not been my friend. What has come to work for me, MOST of the time, is a combination of the following:

1. At bedtime, I drink water with vitamin 1000mg C powder and 500mg magnesium citrate powder dissolved in
2. I eat 1/2 cup of fermented vegetables prior to my first meal of the day, and more after, if needed or desired. After absolutely HATING sauerkraut and kimchee, as a medical experiment I tried this and found that I actually like fermented red cabbage with caraway seeds. Who knew?!
2. Prior to each meal, I take 1 tablespoon of psyllium whole husk fiber (after trying a few, I've settled on Organic India). I put the fiber in the bottom of a glass, add 2 ounces of hot water, then add 6 ounces of cool water and drink it right down. If I wait, it turns in to a disk-shaped gel at the bottom of the glass. No worries...I just drink a lot more warm water with it and swish it between my teeth before I swallow.
3. Immediately prior to each meal, I take 300mg of magnesium (in different forms...citrate, taurate, glycinate...increases likelihood of absorption)
4. About 1 hour after dinner, I take 1 capsule of magnesium threonate, again with 8 ounces of water, which supports cognitive function over the long term. Some sources suggest taking this in the AM, so I may consider this.
5. I can also use abdominal self-massage and some yoga poses (rotating the spine can be quite helpful...my pelvic PT showed them to me) to support movement through my digestive system.

This is a LOT of magnesium, a LOT of fiber and a LOT of vitamin C AND, if I'm doing it right, a LOT, LOT of water. I creeped up to these levels SLOWLY until I got results that now feel comfortable and reliable for me. This is an ever-shifting picture, with me needing less magnesium or more depending on what medications I take (some stop me up on a dime), whether I am traveling, and what else I eat and how active I am able to be.

I send this, not as a prescription, but to say that I do a LOT to prevent constipation, when I can. Sometimes, like someone mentioned previously, I just know that I have to wait until what's causing it is no longer a factor. All that I do feels worth it to me to not be in that kind of discomfort. Having heard that constipation causes what little estrogen I have left to re-absorbed from the gut into the blood-stream in a constant process of recycling, thereby raising my risk of recurrence, made me more attentive to this than ever.

Being woken up too soon and in need of a bathroom tells me I've gone a bit far and I'll benefit from backing down on the magnesium or vitamin C a bit. Any time I feel that I have to push to eliminate is a sign that the balance has shifted toward more constipation and I need to increase what I'm taking, drink more water or be more upright and active in a day. Waking up and being upright and moving around a while and nothing happening tells me I've definitely not done enough. The best is when I start to feel things gently moving through my gut as it starts to function after I've woken up in the morning and I have time to walk downstairs to the bathroom and allow what needs to happen to do so! 🙂

Wishing each and all of you the level of functioning and comfort you need and can find,

Gynosaur

I've been trying to manage constipation and GI issues for almost a year, on Enhertu. If it's not constipation it's diarrhea. Taking meds. and measures for the constipation then swings me into the D-mode, and back it forth it goes. I believe I have IBS, from what I've read about, but no one has diagnosed me.
I discovered I was taking the meds incorrectly: Now, I take 2 Metoclopramide 15 minutes before meals, keeping them 4 hours apart. "It works by increasing muscle contractions in the digestive tract to speed up stomach emptying and by blocking nausea triggers in the brain". Take 1 Pantoprazole 15 minutes before breakfast. " It is used to treat conditions involving excess stomach acid, such as heartburn, gastroesophageal reflux disease (GERD), and stomach ulcers." I've decreased the dosage of Dexamethasone, taking only only 1 per day 4 days after chemo. Side effects include changes in bowel habits, such as diarrhea or constipation. Here are more: https://www.goodrx.com/dexamethasone/common-side-effects.
As for diet: I up my intake of fruit and veg, and try to stay away from simple carbs and even gas producing cruciform vegetables, reduce beans, and whole grains. The brassicas - cabbage, broccoli, kale-- cause gas and bloating, while high fiber grains feel like it doesn't digest, but just sits there under my rib cage, causing my upper abdomen to bulge..
Try to drink drink any fluids, and I do drink a few cups caffeine coffee firs thing in the morning and decaf the rest of the day.
I will take Resoralax the night after chemo and will drink it until I feel it's not working yet.
I had taken Senna initially, but the does on the label was far too strong for me, causing major gut pain and bloating and then explosive BMs, that I've never taken them again.
And for sure, moving helps a lot.
I still haven't found a perfect mix of treatments but the side effects will resolve in 1 to 2 weeks after chemo.

I had terrible constipation followed by terrible diarrhea. It is really a balancing act. Instead of nausea medications I use a heating pad. That really helps the cramping pain. I use a stool softener if needed and try to drink a lot of fluids (a few sips at a time).

Thank you. I got out the heating pad last night and used it. I will try just sipping water because I find I can't get a whole glass down at a time. At least that will keep me hydrated.

@gynosaur42 Wow. That's a lot of dedication. All sounds healthy to me. Unfortunately, I can't take Vit C and I try to keep the magnesium in check, as it can tip over to diarrhea. To prevent that, the doc. recommended Magnesium Bisglycinate (or Glycinate). I take that with Vit D3 for absorption.
Thank you for your suggestions.