Constipation, diarrhoea, faecal incontinence, and bowel obstruction
Bowel problems can occur as part of an advanced illness or as a side effect of medication or treatment. These problems can be distressing and significantly affect the person’s quality of life.
Definition
Constipation is the passage of small, hard faeces infrequently or with difficulty, and they use their bowels less often than is normal for the person.
Diarrhoea can mean either very loose, wet stools, or more frequent bowel movements.
Faecal incontinence is the inability to control bowel movements which leads to unexpected leakage of liquid and/or solid stool.
Intestinal obstruction or bowel obstruction occurs when the movement of gastrointestinal contents is blocked. This can be due to poor bowel function or a malignant tumour. It occurs in 20–50% of people with ovarian cancer and 10–29% of people with colon cancers.
Related Resources
- CareSearch GP Hub – Bowels
- CareSearch Clinical Evidence – Constipation
- palliAGED Practice Tip Sheets – Constipation
- palliAGED Practice Tip Sheets – Faecal incontinence
Key points for all bowel problems
In the following each bowel problem is considered separately. However, there are some important considerations that apply across each of these:
- Red flags related to bowel problems:
- severe vomiting and abdominal swelling indicate possible bowel obstruction
- new back pain or leg weakness indicate possible spinal cord compression
- dark, tarry, or bloody stools indicate possible gastric bleeding
- When providing care with intimate hygiene, it is important to
- respect the person’s care preferences, allowing the person to maintain independence with self-care where possible, physically and cognitively
- maintain normal routines and habits
- maintain privacy boundaries and attention to the tone of care provision
- understand that the person may not want this type of care provided by a close family member.
- People from certain countries or cultures will be used to different styles of toilets and practices in toileting (e.g. sitting, squatting, toilet paper, water rinsing). There may be certain words which are avoided or preferred (e.g. toilet, restroom, bathroom).
- Conversations about bowel habits and problems, particularly diarrhoea and incontinence, can be awkward or embarrassing for the person. To support their dignity acknowledge the possible discomfort and talk in a way which is comfortable for them. Ask if they would prefer to talk to you alone or with someone else. Use clear, plain language and avoid slang words or medical jargon.
- People frequently have an expectation over many years about how often they should use their bowels and get distressed when they cannot use them. This often results in other issues such as haemorrhoids.
- Dehydration can contribute to bowel problems. It can also occur because of bowel problems due to other causes. If appropriate offer the person ice to suck and small amounts of fluid to drink. If the person is dehydrated and not actively dying, intravenous (IV) rehydration may be used initially.
What you can do?
Nurses have an important role in recognising, assessing, and managing symptoms related to bowel function. They can also help patients and families with sensitive and culturally appropriate education and support.
Allied health professionals who can help
A dietitian can provide dietary recommendations for the person and their family and the care team.
Bowel problems resources
Last updated 25 May 2026