The use of nonpharmacologic interventions and its effectiveness in the prevention and management of constipation in the cancer patient after a pancreaticoduodenectomy
Ashley Bakoz
ECPI University
The use of nonpharmacologic interventions and its effectiveness in the prevention and management of constipation in the cancer patient after a pancreaticoduodenectomy
Are nonpharmacologic interventions effective in the prevention and management of
constipation in the cancer patient? I have always been told to walk the patient as soon as they are
able after abdominal surgery. Reasoning being that the act of walking will help with getting the
digestive tract to function again, as normal. While working on the gastrointestinal floor at
MUSC I provided care for a patient diagnosed with pancreatic carcinoma. My patient underwent
a pancreaticoduodenectomy surgical procedure. As a nursing student I wanted to know how I
could help using nonpharmocological interventions in preventing and managing constipation in
the cancer patient. Constipation is a major source of distress for patients with cancer,
significantly affecting quality of life (Woolery, Bisanz, Lyons, Gaido & Yenulevich, 2008). As
the cancer patient is already immunocompromised, having putrefying food lie in the intestines
for a long time they are at greater risk of developing infections as this toxic waste can be
reabsorbed. One safety issue in this type of patient is preventing and managing constipation to
reduce pain and secondary infections. Increased activity and exercise have been considered
beneficial in the prevention and managing constipation by increasing blood flow to the digestive
organs, leading to improved motility (Richmond & Wright, 2004). However, research findings
are conflicting and few RCT’s have supported the hypothesis (Frizelle & Barclay, 2005). A small, descriptive, prospective study (N=50) examining factors influencing constipation in
patients with advanced oncology found no relationship between bowel scores and physical
functioning (Bennett & Cresswell, 2003). Concurrently from reading the research on
nonpharmocological interventions the research is conflicting. Some say increased activity and
exercise are beneficial but from the small prospective study it does not support that physical
exercise and increased activity are effective in preventing and managing constipation in the
cancer patient.
Concluding the end of my research, research shows that pharmacological interventions
are more effective than nonpharmocological interventions being that physical exercise and
increased activity are not very effective in helping with digestive motility. So now I know from
