Constipation is common during cancer treatment. Constipation can be caused by the location of the cancer, limited physical activity, reduced fluid intake, medications, surgery, reduced or restricted food intake, eating a low fiber diet, or eating too many foods that cause constipation. Here are some tips and guidelines to reduce the occurrence of constipation and keep the bowels moving more regularly during cancer treatment:

Increasing your intake of fiber and fluid may help you feel less constipated and bloated. It’s important to understand that there are two types of fiber in the diet: Soluble Fiber and Insoluble Fiber.

Soluble Fiber

Soluble fiber is completely digested by the body and aids in reducing cholesterol, stabilizing blood sugar, and getting rid of other toxins present in the gastrointestinal tract. Soluble fiber functions as a bulking agent and slows down the movement of waste through the gastrointestinal tract. Examples of foods that contain soluble fiber include oats, beans, legumes, sweet potatoes, onions, and fruits such as apples, bananas, and pears.

Insoluble Fiber

Insoluble is not digested by the body and is excreted as waste. This is the type of fiber that promotes bowel regularity and discourages the development of hemorrhoids. Examples of foods that contain insoluble fiber include wheat bran, nuts, seeds, and skins on vegetables and fruits.

Both soluble and insoluble fiber are important for overall good health and nutrition. When you are experiencing constipation, it may be beneficial to include more insoluble fiber in your diet to promote regularity. It is important to increase fiber slowly over the course of a few weeks. Adding too much fiber too quickly can make constipation worse. Below are some general guidelines for alleviating constipation:

Drink plenty of liquids.

  • Fluid helps your body process fiber without discomfort. A good starting goal is eight 8-ounce glasses of fluid per day.

Gradually increase your fiber intake.

  • Your daily goal should be between 25-35 grams daily.
  • Fiber is mostly found in plant foods, such as fruits and vegetables, beans, legumes, whole grain cereals, breads, and oatmeal.

Eat 3-5 servings of fruits and vegetables daily.

  • Choose whole fruit instead of juice.
  • Eat the skins and seeds for extra fiber.
  • Try to have a fruit or vegetable with each meal or snack.

Choose foods that promote regularity.

  • Eat cereals, breads, and pastas that are made with 100% whole grain.
  • Have brown or wild rice in place of white rice or potatoes.
  • Choose hot cereals like oatmeal or cold cereals with at least 5 grams of fiber.
  • Choose whole wheat breads, whole corn or wheat tortillas, and whole grain crackers instead of refined products.
  • Eat more beans, lentils, and peas. Add them to soups and casseroles, or have as a main entrée.
  • Beans are also a great source of protein, so you can use them as a substitute for meat at mealtimes.
  • Beans can be gas forming, so add them gradually. If you experience bloating or discomfort, you may want to limit them in your diet.

Try plum or prune juice.

  • Start with a small amount such as a ½ cup.
  • Eating dried prunes may also help relieve constipation.

Try to include exercise or physical activity in your daily routine.

  • Physical activity is a natural way to help constipation.
  • Always discuss any exercise or physical activity with your healthcare team before making changes.

Talk to your healthcare team about medication or supplements to help with constipation.

  • There are over-the-counter medications that may help with constipation but you should always check with your doctor first before taking anything.

Here are charts with some high fiber choices and their fiber content:

Fruit

Food

Amount

Fiber Content (grams)

Raspberries

1 cup

8.0

Blackberries

1 cup

8.0

Pear

1 medium

4.0

Apple with skin

1 medium

3.0

Strawberries

1 cup

4.0

Blueberries

1 cup

4.0

Banana

1 medium

3.0

Prunes

4 whole dried

6.0

Vegetables

Food

Amount

Fiber Content (grams)

Artichoke

1 cup cooked

14.0

White potato with skin

1 medium

5.0

Sweet potato with skin

1 medium

3.0

Spinach

½ cup cooked

3.0

Broccoli

½ cup cooked

2.0

Cauliflower

½ cup cooked

2.0

Carrots

½ cup cooked

2.0

Asparagus

5 medium

2.0

Tomato

1 medium

1.0

Grains, Beans, Nuts, and Seeds

Food

Amount

Fiber Content (grams)

Bran Cereal

1 cup

20.0

Black Beans

1 cup

14.0

Lentils

1 cup

13.0

Oats

1 cup cooked

4.0

Kidney Beans

1 cup

12.0

Flax Seeds

3 T.

7.0

Peanuts

½ cup

6.0

Brown Rice

½ cup cooked

2.0

Whole Wheat Bread

1 slice

2.0

Spaghetti Noodles

1 cup cooked

2.0

Peanuts

½ cup

6.0

Source: National Fiber Council