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Fiber is a type of carbohydrate that the body cannot digest. It helps to manage sugar (glucose) levels, lower cholesterol, and support digestion. There are 2 main types of fiber: soluble and insoluble. Most plant foods have both.

Insoluble fiber does not dissolve in water. It helps move food through the intestines by adding bulk without removing too much water. This type of fiber is best for preventing and managing constipation.

Soluble fiber dissolves in water and can pull water out of stool. This can make constipation worse because it slows the bowels.

Common sources of soluble fiber include oats, berries, bananas, flaxseed, chia seeds, and psyllium husk. Soluble fiber is better for preventing and managing diarrhea.

Most adults need about 20 to 35 grams of fiber every day.

There are a few types of laxatives. Most of them are taken by mouth (orally).

• Bulk-forming laxatives make the stool swell up to be bulky, softer, and easier to pass.
• Stimulant laxatives irritate nerve endings in the bowel, which causes bowel muscles to move stool along faster.
• Osmotic laxatives draw water into the bowel, making the stool softer and easier to pass.
• Stool softeners make it easier for water to get into the stool, making it softer.

Laxative medicines can be habit-forming and shouldn’t be used for longer than directed.

Always check with your doctor or cancer care team before you start any laxative, including those you can buy at pharmacies or stores (over the counter).

Enemas and suppositories are medicines placed into the rectum through the anus.

• Enemas are liquid and work by softening the stool and lubricating the bowel. Common types include saline, mineral oil, and stimulant enemas.
• Suppositories are soft solids that dissolve or melt at body temperature to soften the stool. Common types include glycerin and bisacodyl suppositories.

Enemas and suppositories are often used for short-term constipation relief. These treatments sometimes work faster than medicines taken by mouth.

These medicines may lead to problems, such as bleeding or infection, in certain people with cancer.

Always check with your doctor or cancer care team before you start taking these medicines, even if they’re available to buy at pharmacies or stores (over the counter).

If you have long-term (chronic) constipation that doesn’t get better with other treatments, talk to your care team. Your provider may prescribe you medicines to help. There are also prescription medicines that can help manage chronic constipation caused by opioid pain medicines.

Pelvic floor muscle (Kegel) exercises can strengthen the muscles that support the bowel, rectum, and anus. Pelvic floor physical therapists are specialists that can help treat incontinence and many other pelvic floor conditions.

The therapist may examine you and use treatments, such as biofeedback, to treat your constipation. Biofeedback uses sensors placed near the anus to show on a screen which pelvic muscles are being used. Therapy done with biofeedback often works better than therapy alone.

You can ask your care team for a referral to a pelvic floor physical therapist. Or if you search for one yourself, check that they are trained in caring for people with cancer.

Contact your insurance to find out whether you need a referral to pelvic physical therapy to cover costs. Learn more about Managing Your Health Insurance and Medical Bills.

• Eat foods that are good sources of insoluble fiber, such as:
  • Wheat bran
  • Quinoa
  • Brown rice
  • Potatoes
  • Fruits with edible skin
  • Almonds, walnuts, and seeds
  • Leafy green vegetables
• Slowly increase your fiber intake until you reach your daily goal of 20 to 35 grams of fiber. Adding fiber too quickly can lead to bloating or worsening constipation.
• Drink enough fluids, especially when you eat more fiber.

• Get more physical activity, such as walking. Movement helps the muscles in your intestines move stool along.
• Try to have a bowel movement around the same time each day. Your bowels are more active after eating and walking.
• Place a footrest in front of the toilet. Raising your feet 8 to 12 inches above the ground can make it easier for your body to pass stool.

If gas and bloating happen, you may want to limit foods and drinks, such as:

• Dairy
• Eggs
• Apples
• Avocados
• Beans
• Vegetables including peas, cabbage, broccoli
• Fizzy or carbonated drinks

Gas can also be caused by chewing gum and drinking through straws.