About one-third of
cancer patients who receive
opioid drugs to control
pain experience
constipation. While clinical healthcare personnel often deal with
constipation problems by adopting professional suggestions, effective evidence-based solutions remain lacking. Thus,
cancer patient
constipation problems are often not effectively solved. In this article, 2009 American National Comprehensive
Cancer Network guidelines for
palliative care in
cancer were modified as the basis of evidence-based nursing research.
Constipation assessments should first be conducted before the initiation of
opioid drug treatment to relieve
pain in
cancer patients. Before the patient develops
opioid-induced constipation, preventive action should be conducted, such as using
drug combinations (e.g.,
sennoside and
docusate). Non-
pharmaceutical interventions include exercising, maintaining a high-fiber diet, conducting abdominal
massage and having correct bowel habits. If the patient is already experiencing
constipation,
bisacodyl (ducolax) may be used. However, if no improvement is observed,
pharmaceutical treatments (e.g., a
lactulose-
sennoside combination) may be administered. If stool impaction occurs during the testing process, digital and
glycerine should be implemented to remove stool impaction. Eliminating stool impaction enhances medication effectiveness. Nurses should advise doctors regarding preventive measures related to commencing treatment with
opioid drugs. Further, nurses must evaluate degree of
constipation and educate patients on following non-
pharmaceutical strategies to alleviate
constipation to improve quality of life.