How to manage constipation in tumor patients?

There are many triggering factors for constipation in oncology patients, which makes it difficult to treat. Tumor factors, metabolic factors, therapeutic factors, psychiatric factors, physiological factors are the common causes of constipation in oncology cancer patients. Constipation occurs in patients often manifested as general discomfort, irritability, abdominal distension, loss of appetite, poor appetite, etc., and defecation 1-2 times per week. Patients with malignant tumors often have anxiety, nervousness, depression, these negative emotions can cause or aggravate vegetative nerve dysfunction, affecting gastrointestinal motility and endocrine function, leading to gastrointestinal dynamics and dysfunction; at the same time, negative psychology can also affect appetite, patients eat less, not enough to cause defecation reflexes, which leads to constipation. Some drugs can directly affect defecation, now known oncology analgesic drugs such as Mescaline, Fentanyl transdermal patch, Tramadol, Morphine, Prednisolone, Valium, etc., as well as bio-immune drugs can cause constipation, and the degree of the drug dose with the incremental increase in the enhancement. Clinically used in some Chinese medicine preparation odor is too heavy, the patient is difficult to accept, some tablets of drugs orally most patients feel nausea, especially during chemotherapy, gastrointestinal reaction is obvious, many of the laxative application of drugs should be careful. Nutritional dietary preparation is the best way to prevent and treat constipation, the patient is easy to accept, three meals a day in the preparation of taste and flavor, such as: a variety of bean sprouts, seaweeds (kelp, wakame, etc.), vinegar beans, white carrots, spinach, garlic, etc., have a very good laxative effect. For gas, blood deficiency patients with appetizing digestive drugs, regulating the patient’s gastrointestinal function, increase appetite, promote intestinal peristalsis, consumption of groundnut that is nutritious and anti-cancer; corn, carrots are rich in minerals and vitamins. Patients taking honey during chemotherapy both clear heat and detoxification, can reduce the toxic side effects caused by chemotherapeutic drugs, patients adhere to long-term use of constipation can be prevented from reoccurring. Tumor patients should follow the application of laxatives three principles: one is to avoid the use of as much as possible; two must be used when the dosage is as small as possible, not easy to frequent use of medication; three has been the use of laxatives should try to gradually stop the drug; four is a laxative shall not be used for a long time and should be frequently replaced varieties. For patients with constipation who really need medication, nurses also need to understand the effect of the correct use of drugs. After the use of laxative drugs, the nurse should carefully observe and record the patient’s defecation volume, defecation time, nature and color, etc., on the “abuse” and long-term use of laxatives to be corrected in a timely manner and to do a good job of patient defecation medication guidance. While guiding and helping patients to carry out dietary treatment, instructing patients to develop good dietary and defecation habits, increasing the strength and coordination of defecation muscles, promoting the passage of colonic contents, and making the feces smoothly discharged. Ask the patients to do defecation movement with force after breakfast or waking up in the morning regardless of whether they have the intention to defecate or not, tell the patients to clench their fists with force with both hands when defecating, press the palm with force with the middle finger, and press both hands on the abdomen to do coughing movement to increase the abdominal pressure and promote defecation. At the same time, focus your attention, do not read newspapers or do other things at the same time, and do not smoke. Maintain a relaxed and happy mood have a regular life, appropriate exercise; such as walking, brisk walking, doing calisthenics and so on. If the condition permits, ensure enough drinking water, drink 400-500 ml of warm boiled water every morning after getting up, in order to ensure enough water in the body to moisten the intestine and soften the stools, so that the intestinal water is sufficient in 1 hour before the activity, and develop the habit of defecation at this time, so as to avoid the intestinal absorption of water after getting up to avoid constipation caused by defecation difficulties. In addition, we should do a good job of psychological care for tumor patients, communicate with them, understand their psychological state and stool condition, and carry out corresponding nursing measures in time. Help patients to improve coping behavior, reduce irritability and anxiety, maintain a good mental state, and actively cooperate with the treatment.