 This is a short talk about constipation. The short presentation is intended to inform you and your loved ones about strategies for managing the side effects associated with targeted therapies. As someone with a diagnosis of kidney cancer, you've probably had your fill of clinics and doctors. You've probably been poked and prodded and stuck with needles and have symptoms that are new and different that you don't like. The last thing you probably want to do is to hear about one more symptom. You may experience as a result of what you are going through. It is also a symptom that can be difficult and embarrassing to talk about, but one that is important to discuss if it becomes a problem. Just know that this problem is not uncommon and your doctors and nurses are interested in talking to you if you need help. You are listening to this webinar because you are interested in hearing about constipation. So what exactly is constipation? Constipation is defined as having infrequent bowel movements or difficult passage of stools, or both. Constipation is a common problem. Of course, what is considered a normal frequency for bowel movements varies widely from one person to another. In general, however, you are probably experiencing constipation if you pass fewer than three stools a week and your stools are hard and dry. Constipation most commonly occurs when waste or stool moves too slowly through the digestive tract, causing it to become hard and dry. Normally, the waste products of digestion, stool, are propelled three or intestines by muscle contractions. In the large intestine, the colon, most of the water and the salt in this waste mixture are reabsorbed because they are essential for many of your body's functions. However, when there is not enough fluid or fiber rich food in your diet, or if the colon's muscle contractions are slow, the stool hardens, dries, and passes through your colon too slowly. This is the root cause of constipation. You are more likely to have constipation if you are an older adult, don't get any exercise, are confined to bed, eating a diet that is low in fiber, not getting enough fluids, or taking certain medications including sedatives and narcotics, or certain medications to lower your blood pressure or to treat some kinds of cancer. You may also experience constipation if the muscles you use to move your bowels aren't properly coordinated due to surgery or nerve damage. Fortunately, most cases of constipation are temporary. Simple lifestyle changes such as getting more exercise, drinking more fluids, and eating a high fiber diet can go a long way toward alleviating constipation. Constipation may also be treated with over-the-counter laxatives and stool softeners. Not having a bell movement every day doesn't necessarily mean you're constipated. You probably do have constipation, however, if you've had at least two of the following signs and symptoms for at least three out of the past six months. Do you pass fewer than three stools a week? Are you experiencing hard stools? Are you having to strain excessively during bowel movements? Do you experience a sense of being blocked up? Have you a feeling of incomplete emptying after having a bowel movement? Although constipation may be bothersome, it's not usually serious. Most people who have constipation don't even seek a doctor's care. However, chronic constipation may lead to complications or be a sign of serious underlying problems. Contact your doctor or nurse if you experience an unexplained onset of constipation or change in bowel habits, or if symptoms are severe, last longer than three weeks, or interfere with your daily activity. Also, seek medical care if you experience bowel movements that occur more than three days apart, despite corrective changes in your diet or exercise. Contact your doctor if you have intense abdominal pain, blood in your stool, or constipation that alternates with diarrhea. Also, let your doctor know if you're having rectal pain or thin pencil-like stools or unexplained weight loss. A number of factors can cause an intestinal slowdown, including inadequate fluid intake or dehydration, inadequate amounts of fiber in your diet, ignoring the urge to have a bowel movement or delaying until later. A lack of physical activity, especially in older adults, irritable bowel syndrome, changes in lifestyle or routine, including pregnancy, aging, and travel-related illnesses, frequent use or misuse of laxatives, specific diseases such as cancer, stroke, diabetes, thyroid disease, and Parkinson's disease, problems with the colon and rectum, such as intestinal obstruction or out-pocketing in the intestinal wall. Certain medications, including opiate pain medications, diuretics and those used to treat Parkinson's disease, and high blood pressure and depression medications also can cause constipation. Anal fissures and hemorrhoids, which can produce a spasm of the anal sphincter muscle and cause you not to be able to have a bowel movement, loss of body salts through vomiting or diarrhea, and injuries to the spinal cord, which can affect the nerves that lead to and from the intestine. If constipation persists, and especially if straining results, you may develop certain complications, such as haemorrhoids or cracks, fissures in your anus, which may result when hard stool stretches the sphincter muscle. Fecal impaction, which occurs when you accumulate a mass of hardened stool that can't be eliminated by normal bowel movements, this can be a problem. You may need to have the impacted stool removed manually by your doctor. Rectal prolapse can occur when a small amount of the rectal tissue pushes out through the anus. This condition may lead to a secretion of mucus. And last but not least, lazy bowel syndrome, which may occur if you use laxatives too frequently, causing your bowels to become dependent on them for proper function. Long-term laxative use can also lead to other problems, including poor absorption of vitamins and other nutrients and damage to your intestinal tract. Constipation may occur with some cancer treatments and pain medications, or if you have not been drinking enough fluids, a diet high in fiber with adequate fluid intake will help correct this problem. Increase intake of fluids to eight or more glasses of fluid a day. Make sure you have regular daily exercise. Changing your diet can help to lessen or prevent constipation. Try to maintain a balanced diet, including protein, cereals, and fruits and vegetables. Include proteins such as legumes, beans, lentils, and split peas. Avoid cheese in large quantities. Include whole grain breads and cereals, brown rice, bran and fruit muffins, raisin and oatmeal cookies, granola, and similar whole grain products. Avoid refined grains and breads and low-fiber cereals such as rice. Include raw fruits and vegetables, fruits with seeds such as raspberries, peas, broccoli, carrots, spinach, dried fruits, and fruit juices. Try to avoid bananas. If changes in your diet and activity do not help, contact your doctor or nurse for further recommendations and for possible addition of a stool softener or a laxative to help correct the constipation. Besides diet, exercise is important to help prevent constipation. A daily routine of exercise, such as walking, can help prevent constipation. When used in combination with a diet rich in fiber and fresh fruits and vegetables, you'll be able to beat this problem. In conclusion, constipation is a common problem. Many factors can cause constipation. Simple lifestyle changes such as increasing exercise and adding more fluids and high fiber foods to your diet can be helpful in correcting the problem. Constipation can be embarrassing to talk about with your doctor or nurse, but they are there to help you and can make suggestions and make a difference. It might help you with this all too common problem.