Bowel problems towards the end of life

Pancreatic cancer and treatments can cause bowel problems, such as:

• finding it harder to poo (constipation)
• runny poo (diarrhoea)
• pale, oily poo that floats, smells horrible and is difficult to flush down the toilet (steatorrhoea).

Speak to your doctor or nurse if you have any bowel problems. They can work out what is causing it, and find ways to help manage it.

Constipation

Constipation can be very uncomfortable. It can cause bloating, pain and make you feel or be sick.

You may be more likely to get constipation it if you aren’t moving around or eating much, or are dehydrated. It can help to drink plenty of fluids, if you can.

You may get constipation if you are taking strong painkillers called opioids, such as morphine. You should be given medicines called laxatives to take with opioids. These prevent constipation. Take the laxatives regularly. If you can’t take laxatives, it is important to continue taking the opioid painkillers, and speak to your medical team. They may be able to help you find a way to deal with the constipation.

Diarrhoea

Diarrhoea can be caused by different things, such as the cancer, some medicines, or an infection.

If you have diarrhoea that doesn’t get better, or you have diarrhoea several times a day, tell your GP or nurse.

If you have diarrhoea, try to keep your bottom clean using wipes or damp cotton wool. Wash the area using gentle soap and water, and pat dry. Wear cotton underwear and loose fitting clothes. If your bottom is sore, your doctor or nurse may recommend a cream to use.

Try to drink plenty of fluids so you don’t get dehydrated. It can be easier to have small, frequent sips.

Dehydration

Dehydration is where your body loses more water than it takes in. It may be more likely if you have diarrhoea or are being sick.

If you are dehydrated you might have dark pee, headaches, feel thirsty, and feel dizzy or light headed. Speak to your doctor or nurse if you think you might be dehydrated, or if you have diarrhoea or are vomiting and have any of these signs. They may be able to treat the dehydration, or help you get more fluids if you are not drinking as much as you normally would.

Steatorrhoea

Steatorrhoea is caused by fat in your poo. Your poo may be pale, oily, smell horrible and be difficult to flush down the toilet. You may get it if your body can’t digest the fat in your food properly. Pancreatic enzymes can help with steatorrhoea.

Overflow diarrhoea

Sometimes if you have constipation, some watery poo which looks like diarrhoea can leak out. This is called overflow diarrhoea.

If you are taking opioid painkillers, you may be taking laxatives to prevent constipation. If you think you have diarrhoea, don’t stop taking the laxatives and don’t take any medicines to stop diarrhoea. It may be overflow diarrhoea. Speak to your nurse about what to do. They can work out what is causing it and how to manage it.

Published August 2024

Review date August 2027