Assessment of Constipation in Patients With Cancer

© 2016 Harborside Press® Constipation, a significant problem for many cancer patients, often leads to significant physical and psychological distress. Clinicians must recognize constipation in a timely manner to optimize management and minimize its adverse effects (Andrews & Morgan, 2013). There is no single accepted definition of constipation, which patients and clinicians often view differently (Clark, Urban, & Currow, 2010). For example, in one small study of cancer patients undergoing palliative care, patient ratings of constipation severity were influenced more by ease of passing stool than frequency of bowel movements or stool consistency (Brown, Lawrie, D’Sa, Wilcox, & Bennett, 2006; McCrea et al., 2008). Patients may say they are constipated if they experience any of several changes in bowel movements, whereas clinicians usually view constipation as hard and infrequent stools (Izumi, 2014). Other authors have reviewed constipation assessment tools and generally agree that constipation is subjective and should be assessed by patient report. Instruments should capture the severity of constipation as well as the quality-of-life effects from it. Although there are no agreed-upon instruments to assess constipation in cancer patients, clinically useful tools would balance the length and complexity with information provided to minimize patient burden and gather useful data to evaluate constipation severity and direct management. Although others are available, the patient-rated scales selected for this review are valid, brief, and clinically useful.