Bowel changes

After surgery or during chemotherapy or radiation therapy, some people notice problems with how their bowel works. You may experience diarrhoea, constipation or stomach cramps. Pain relief medicines may also make you feel constipated. Diarrhoea and constipation can occur for some time, but are usually temporary.

Sometimes tissues in the pelvis stick together after surgery (pelvic adhesions). This can lead to ongoing bowel problems and pain and in rare cases may need further surgery. To help manage bowel changes, ask your doctor, nurse or dietitian for advice about eating and drinking, and see the tips below.

For more on this, see Nutrition and cancer.

Learn more about:

• Tips for managing bowel changes
• Treating a blockage in the bowel

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Tips for managing bowel changes

• Drink plenty of liquids to replace fluids lost through diarrhoea or to help soften faeces (poo) if you are constipated. Avoid alcohol, caffeinated drinks and very hot or very cold liquids.
• Avoid fried, spicy or greasy foods, which can cause pain and make diarrhoea and constipation worse.
• Ask your pharmacist or doctor about suitable medicines to relieve symptoms of diarrhoea or constipation.
• Eat small, frequent meals instead of three big ones.
• Drink peppermint or chamomile tea to reduce stomach or wind pain.
• If you have diarrhoea, rest as much as possible – diarrhoea can make you very tired.
• If you are constipated, do some gentle exercise, such as walking.

Treating a blockage in the bowel

Surgery for ovarian cancer sometimes causes the bowel to become blocked. This is called a bowel obstruction. A bowel obstruction can also occur if the cancer comes back. Because faeces (poo) cannot pass through the bowel easily, symptoms may include feeling sick, vomiting, or a swollen and painful stomach.

A bowel obstruction can sometimes be treated by resting the bowel, which means you have nothing to eat or drink until the blockage clears. Your doctor may also try giving you an anti-inflammatory medicine to reduce the swelling around the obstruction.

Some bowel obstructions require a surgical procedure. If only one area is blocked, you may have a small tube (stent) put in to help keep the bowel open and relieve symptoms. The stent is inserted through the rectum using a flexible tube called an endoscope.

If the bowel is blocked in more than one spot, you may have surgery to create a stoma, an opening in the abdomen that allows faeces to leave the body. A stoma may be a colostomy (made from the colon, part of the large bowel) or an ileostomy (made from the ileum, part of the small bowel).

A small bag called a stoma bag or appliance is worn on the outside of the body to collect the waste. A stomal therapy nurse will show you how to look after the stoma. The stoma may be reversed when the blockage is cleared, or it may be permanent.

To find out more, call Cancer Council 13 11 20, or visit the Australian Association of Stomal Therapy Nurses or the Australian Council of Stoma Associations.