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Constipation, diarrhoea and bowel problems

You may experience some bladder and bowel problems because of your illness, medication or treatment. These problems can be distressing, but there are things that you can do to manage them.

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Constipation is when you’re not able to pass a stool and it becomes stuck in your bowel. It can be very uncomfortable and cause other problems.

Managing constipation

There are a number of things you can do to try to avoid or relieve constipation:

  • Make sure you drink enough fluid – six to eight cups (two litres) every day if possible.
  • Have a warm drink first thing in the morning but try to avoid having too many drinks containing caffeine.
  • Avoid alcohol.
  • Increase the amount of fibre you eat – try eating a high fibre cereal and wholemeal bread, prunes or prune juice, plums or rhubarb (unless you have been advised to follow a low fibre diet)
  • Eat more fruit and vegetables – fruit cake, digestive or bran biscuits might also help.
  • Keep as active as possible.
  • Try to develop a regular routine and give your bowels time to work.
  • Go to the toilet when you feel the urge. Don’t ignore the urge to go as this can make your constipation worse.

It may not always be appropriate to increase the amount of fibre in your diet, for example if your appetite is poor or you aren’t drinking enough. Check with your nurse or doctor.

You should talk to your nurse or doctor if you:

  • have persistent constipation, for example for more than four days
  • have pain in your stomach or bottom
  • feel or have been sick
  • experience bleeding from your bottom
  • pass a watery stool after having constipation

They can assess whether there’s a particular cause, decide if you need any medical treatment and give you advice.

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Diarrhoea can mean either very loose, wet bowel motions, or more frequent bowel motions or a new pattern of incontinence. If you have diarrhoea you may also experience:

  • stomach cramps
  • needing to go to the toilet urgently
  • nausea or vomiting
  • headaches
  • loss of appetite

Causes of diarrhoea

There are many causes of diarrhea, including:

  • side effects of treatments
  • an infection
  • your illness itself
  • anxiety
  • your diet
  • food intolerances

Managing diarrhoea

Most cases of diarrhoea clear up within a few days without treatment, but if you have frequent diarrhoea, or if you see blood or pus in your faeces (poo), you should talk to your nurse or doctor who can advise whether you can take anti-diarrhoea medicine or painkillers, as well as exploring any other treatment that may be needed. You might need to provide a stool sample.

Diarrhoea   can make you dehydrated so you should make sure you drink plenty of fluids. Eat solid foods as soon as you feel able to. Start with small amounts and avoid fatty, spicy or heavy foods.

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Overflow diarrhoea

Severe constipation can cause a blockage in your bowel. Because of this, the bowel begins to leak out watery stools around the blockage from higher up in the bowel.

The leak from the bowel can look like diarrhoea . It’s called ‘overflow diarrhoea’. In this situation you shouldn’t take anti-diarrhoea medicines.

If you’ve had severe constipation and then develop diarrhoea, you should talk to your doctor or nurse before taking any more medicine for digestive disorders.

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Bowel obstruction

Some people with terminal illness can experience bowel obstruction. This occurs when the intestine is partly or completely blocked. There are a number of causes including:

  • illness, like bowel, gynaecological or abdominal cancers or kidney disease
  • infections
  • complications of surgery
  • hernias

For example, for bowel obstruction can affect people with cancer when cancer cells stick onto the lining of the bowel wall. This makes it thicker and stiffer so it doesn’t stretch and push food along to the end the way it should. Or, if you have fluid collecting in your abdomen from a condition known as ascites, it can cause your bowel to work more slowly.

Sometimes it’s difficult for bulky food to pass through these narrow areas and it can get stuck. The bowel can then become swollen and full of liquid. Some food can get through, but it’s a bit changeable and this can lead to erratic bowel motions. This can cause constipation and diarrhoea. The blockage can also cause vomiting if the bowel starts to push the other way.

Common symptoms of bowel obstruction are:

  • feeling bloated all the time
  • a lot of gurgling noises from your abdomen area
  • feeling full after only a little food
  • constipation or a mix of constipation and diarrhoea
  • abdominal pain that comes in waves
  • nausea and sometimes vomiting foul smelling liquid
  • heartburn
  • not passing any flatulence (wind)

Bowel obstruction can be complex to manage. It’s important to seek advice from your nurse or doctor if you’re experiencing any of these symptoms. Treatment options can range from medications to surgery to diet restrictions.

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Bladder problems

Some illnesses, like cancer and neurological conditions, previous gynaecological problems, and treatments can cause bladder problems. Some people may lose their ability to control their bladder or have difficulty in emptying their bladder. Other problems include:

  • needing to pee more often or not peeing very often (known as urinary retention)
  • leaking urine
  • blood in the urine
  • having a burning sensation when peeing

If you notice bladder changes you should speak to your nurse or doctor who can check if there’s a specific cause and they can recommend appropriate treatment for you.

If you haven’t passed urine within a 24 hour period, contact your doctor straight away.

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External websites

NHS Choices website   – diarrhoea

NHS Choices website   – constipation

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This page is for general information only. It's not intended to replace any advice from health or social care professionals. We suggest that you consult with a qualified professional about your individual circumstances. Read more about how our information is created and how it's used.

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