Constipation

Constipation is a common presenting problem for the oncologic patient. Due to varying definitions and differing base populations, the reported prevalence range is broad, from 1% to 80%. Constipation causes distressing and disabling symptoms, imposes large burdens on the cancer healthcare system, and results in excessive healthcare costs. Patient morbidity and healthcare costs can be reduced by focusing on preventive measures for those at elevated risk. While the etiology of constipation is multifactorial, there are certain causative factors that are more common among those with cancer. In this chapter, we explore factors predisposing to constipation in the oncologic cohort, including opioid-induced constipation and hypercalcemia of malignancy, and review the clinical manifestations of cancer-associated constipation. We discuss epidemiology, pathophysiology, clinical manifestations, differential diagnosis, and diagnostic pitfalls in the emergency department, as well as treatment protocols, prevention measures, and patient education.