Diffuse Abdominal Pain

doi:10.1017/9781009500760.027

Chapter 27 - Diffuse Abdominal Pain

Published online by Cambridge University Press: 24 April 2026

Ambika Anand and

Carrie Maupin

Edited by

Angela Bray Lindsay and

Monica Kathleen Wattana

Show author details

Angela Bray Lindsay: Affiliation:
Virginia Commonwealth University
Monica Kathleen Wattana: Affiliation:
University of Texas, MD Anderson Cancer Center

Book contents

Get access

Summary

1. Causes of constipation in patients with cancer are multifaceted, but opioid induced constipation is the most common cause.

2. Constipation in cancer patients can lead to serious complications, including fecal impaction, bowel obstruction, and decreased absorption of oral medications, which can impact the effectiveness of cancer treatment.

3. Bulking agents can be used in mild cases of constipation but should be avoided in patients with severe disease, taking anticholinergic drugs or opioids, and those with poor oral intake.

4. Stool softeners can be helpful in patients with anal fissures or hemorrhoids to allow for less painful bowel movements. Polyethylene glycol is recommended as first line due to its low cost, rapid onset, and rare adverse side effects.

5. Peripherally acting mu-opioid receptor antagonists (PAMORA) bind only to opioid receptors in the gut, counteracting constipation side effects without decreasing analgesic effects.

Keywords

Constipation cancer opioids pain abdominal pain bowel regimen methylnaltrexone oncologic emergency

Information

Type: Chapter
Information: Oncologic Emergency Medicine
Clinical Cases Illustrating Key Concepts
, pp. 133 - 136

DOI: https://doi.org/10.1017/9781009500760.027 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2026

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Book purchase

Temporarily unavailable

References

Accessibility standard: WCAG 2.1 AA

Why this information is here

This section outlines the accessibility features of this content - including support for screen readers, full keyboard navigation and high-contrast display options. This may not be relevant for you.

Accessibility Information

The HTML of this chapter complies with version 2.1 of the Web Content Accessibility Guidelines (WCAG), covering newer accessibility requirements and improved user experiences and achieves the intermediate (AA) level of WCAG compliance, covering a wider range of accessibility requirements.

Content Navigation

Table of contents navigation
Allows you to navigate directly to chapters, sections, or non‐text items through a linked table of contents, reducing the need for extensive scrolling.

Index navigation
Provides an interactive index, letting you go straight to where a term or subject appears in the text without manual searching.

Reading Order & Textual Equivalents

Single logical reading order
You will encounter all content (including footnotes, captions, etc.) in a clear, sequential flow, making it easier to follow with assistive tools like screen readers.

Short alternative textual descriptions
You get concise descriptions (for images, charts, or media clips), ensuring you do not miss crucial information when visual or audio elements are not accessible.

Full alternative textual descriptions
You get more than just short alt text: you have comprehensive text equivalents, transcripts, captions, or audio descriptions for substantial non‐text content, which is especially helpful for complex visuals or multimedia.

Visual Accessibility

Use of colour is not sole means of conveying information
You will still understand key ideas or prompts without relying solely on colour, which is especially helpful if you have colour vision deficiencies.

Structural and Technical Features

ARIA roles provided
You gain clarity from ARIA (Accessible Rich Internet Applications) roles and attributes, as they help assistive technologies interpret how each part of the content functions.