Analysis of the causes of constipation in cancer patients after chemotherapy and countermeasures

  Constipation is one of the common complications after chemotherapy for cancer patients. Constipation not only leads to emotional problems such as irritability and anxiety, but also easily causes anal fissure. The immunity of cancer patients is obviously reduced after chemotherapy, and once anal fissure occurs, it is easy to cause perianal infection, and in serious cases, bacteria may enter the blood circulation from the local breakage and lead to bacteraemia, which further affects the smooth progress of chemotherapy.  Factors related to the occurrence of constipation after chemotherapy for cancer patients are as follows: 1. Dietary factors: In order to strengthen nutrition, cancer chemotherapy patients often eat too fine, coupled with insufficient fiber and water intake, resulting in a lack of intestinal power, and because the stool can not be fully softened, resulting in constipation.  2, lack of exercise: chemotherapy patients often due to physical weakness, reluctance to get out of bed activities, reduced activity leads to intestinal peristalsis is weakened, easy to cause constipation.  3, eating less: chemotherapy patients due to poor appetite, eating less, food residues are relatively reduced, so the stool volume is also reduced.  4, adverse reactions of chemotherapy drugs: chemotherapy drugs cause nausea, vomiting and reluctance to drink water, resulting in a decrease in body water, furthermore, the general stool volume is small and dry, not easy to eliminate.  5.Opioid adverse reactions: most of the cancer patients have different degrees of pain, the application of opioid drugs to a certain extent to reduce the patient’s pain, but on the other hand also weakened the peristalsis of the gastrointestinal tract, easy to cause constipation.  6, mental psychological factors: chemotherapy patients often anxiety, tension, and anxiety can increase the tension of the pelvic floor muscles, which leads to contradictory movement of the anorectum during defecation, resulting in constipation.  7, ignore the defecation signal: patients due to treatment or environmental factors, when the emergence of bowel movements sometimes restrain or hold back and do not immediately defecate, so that over time will make the defecation reflex gradually disappear, and then lead to constipation.  Countermeasures 1, before chemotherapy for chemotherapy drugs may appear adverse reactions in detail to the patient, so that they have adequate mental preparation, with the corresponding preventive measures, in addition, in order to reduce the occurrence of pharmacogenic constipation, the doctor should be a comprehensive assessment of the patient, master the type and dose of drugs.  2, dietary guidance: guide patients to eat light and easily digestible food, eat less and more meals, while increasing the variety of food to enhance the patient’s appetite, eat more fresh fruits and vegetables and legumes containing coarse fiber to increase the peristalsis of the gastrointestinal tract, encourage more water, chemotherapy patients before, during and after the use of chemotherapy drugs to drink sour milk, can effectively prevent the occurrence of constipation.  3, appropriate exercise: according to the specific situation of patients to choose the appropriate exercise, bedridden patients should be instructed to perform abdominal massage, supine, relaxed, can be active or passive operation, the palm of one hand on the navel directly above, with the thumb and four fingers from right to left along the colon massage to promote intestinal peristalsis, to promote defecation.  4.Psychological care: frequently visit patients, communicate with them, help them improve coping behavior, reduce irritability and anxiety, and maintain a good mental state.  5.Medicinal food treatment: a. Astragalus honey porridge: Astragalus 10g, 100g rice, honey appropriate amount. Astragalus select clean, water decoction to get juice, plus rice porridge, to be cooked when the transfer of honey, and then boil one, two boiling that is. Drink warm and take. 1-2 times a day. Can benefit the blood, laxative, for the elderly, after the disease, postpartum constipation, defecation weakness, fatigue after the stool.  b. Hu Ma Ren porridge: Hu Ma Ren 10g, 100g rice, sugar appropriate amount. The caraway seeds will be selected, fried and set aside. First, the rice purity, put into a pot, add water to cook the appropriate amount of porridge, to be cooked when the transfer of caraway, sugar, etc., and then boil one, two boiling that is. Once a day, for 3-5 days can laxative. Suitable for senile constipation, constipation after illness and women’s postpartum constipation.  c, honey porridge: rice 50g, honey appropriate amount. The rice is cleaned, put into a pot, add the right amount of water to cook the porridge, when cooked, mix in honey, and then boil one, two boiling is ready. Once a day for three to five days. It can moisten the lungs and stop coughing, laxative and laxative, suitable for tiredness and less food due to deficiency of the spleen and stomach, pain in the abdomen, lung deficiency and prolonged cough, or prolonged cough, and constipation due to deficiency of body and fluid.  d. Potato porridge: 100g potato, 50g rice. peel potato, wash, cut, put into pot with rice, add water and cook porridge. Once a day for 3-5 days. It can benefit the qi and strengthen the spleen, detoxify and relax the bowels. Applicable to the spleen and stomach deficiency caused by the epigastric pain, constipation, pediatric chicken pox, etc.  6, warm water foot soak: 30 minutes every night before bedtime foot soak, water temperature 39-42 degrees, the water level above the ankle. Through the water temperature to stimulate the feet. Make the reflex zones of the small intestine, colon and anus on the bottom of the feet active blood circulation and promote intestinal peristalsis.  7.Medication: Laxatives with different principles of action can be selected according to the specific conditions of the patient. According to its principle of action, laxatives are divided into (1) volumetric laxatives (2) hypertonic laxatives (3) salt laxatives (4) lubricating laxatives (5) stimulating laxatives (6) gastrointestinal motivational drugs.  8, enema treatment: enema is the patient is reluctant to accept the treatment, but in some patients without timely prevention and treatment of constipation and part of the long-term disease of physical decline, elderly patients with intractable constipation, enema is sometimes unavoidable. Should be as far as possible through timely prevention and treatment of constipation, avoid enema therapy becomes routine, because the enema treatment will lead to intestinal mucosal damage and loss of intestinal wall mucus, these mucus has the role of lubricating the intestinal wall.