Diarrhea means having bowel movements that are soft, loose, or watery more often than normal. It may or may not cause pain or discomfort in the abdomen and/or rectum. It’s one way patients may lose a lot of water from their bodies in a relatively short period of time.
Cancer treatments, especially chemotherapy and radiation therapy, or the cancer itself, may cause diarrhea or make it worse. Some medicines, infections, and stress can also cause diarrhea. Patients who are constipated may also have leakage of diarrhea.
If diarrhea is severe or lasts a long time, the body does not absorb enough water and nutrients, which can cause you to become dehydrated or malnourished. Because of this, it should never be ignored or left untreated as a cancer patient.
Ways to Manage Diarrhea While Going Through Cancer Treatment
The following information has been provided to help you manage and control this side effect.
Drink plenty of fluid each day. Most people need to drink 8 to 12 cups of fluid each day. Liquids including sports drinks (like Gatorade), clear fruit juices (apple, cranberry, grape), ginger ale, clear broth, and water are better options. Avoid coffee, tea, alcohol, milk or milk products, since they can make diarrhea worse. For severe diarrhea, only clear liquids or IV (intravenous) fluids may be advised for a short period.
Check with your doctor or nurse before taking diarrhea medications. Avoid medications such as Reglan, stool softeners, laxatives, or fiber supplements. Instead choose over-the-counter anti-diarrhea medications, such as Imodium AD. Your oncologist or physician can also prescribe medicine for you.
Keep your anal area clean and dry. Try using warm water and wet toilet paper wipes to stay clean. It may help to take warm, shallow baths, called sitz baths. You may also consider using over-the-counter products for relief of hemorrhoid inflammation that can be caused by diarrhea.
Quit smoking. Smoking can affect your digestive system. It may also raise your risk for bacterial infections that affect the intestines and cause diarrhea.
Alter your diet. Eat small meals that are easy on your stomach, such as white rice, eggs, baked potatoes, cooked cereals, bananas, macaroni and pasta, white toast, and smooth peanut butter. Eat six to eight small meals throughout the day, instead of three large meals. Foods high in potassium and sodium (minerals you lose when you have diarrhea) are good food choices, for most people.
Limit or avoid foods and drinks that can make your diarrhea worse. These include foods like onions, beans, cabbage, peas, broccoli, cauliflower, whole grain breads and cereals, nuts, and popcorn. Sugar-free gums and candies, as well as greasy, deep-fried, fatty foods, and rich sauces can also worsen diarrhea.
Low Fiber and Low Fat Diet Suggestions
The following diet suggestions are made available to help you avoid foods that will cause bowel irritation and increase diarrhea. Making these changes in your diet can often control diarrhea in mild cases. You do not need to start this diet until you are having increased stools (more than 2 over your normal).
| FOODS TO ELIMINATE | FOODS TO SUBSTITUTE |
| Fresh fruits and vegetables (except bananas) | Bananas |
| Canned pineapple, oranges, grapefruit | Canned fruits except those listed |
| Citrus juices (orange or grapefruit), prune juice, tomato juice | Pear and peach nectars, apple juice |
| All whole grain cereals, breads, or brown rice, rice, cereals including whole wheat, bran, oatmeal, rye | White bread, corn breads, white cereals (corn & rice) |
| Tomatoes or tomato based foods such as spaghetti | All other canned vegetables not on the avoidance list |
| Any gas producing foods such as cooked or dried beans, brussel sprouts, broccoli, cabbage, etc. | |
| Nuts raisins, popcorn, seeds, donuts, rich desserts | May snack on dried cereals, plain flour cookies, cakes |
| Spicy "HOT" foods (Mexican, Italian, Chinese, Barbecue, Pizza, etc.) | All bland foods (macaroni, noodles, potatoes, etc.) |
| Fried Foods, processed meats (fried chicken, meat, hamburger, bologna, salami, etc.) | All other baked, broiled, stewed foods |
| Alcoholic beverages, caffeine (No more than two cups of coffee or caffeine products daily) | Water, Gatorade or other electrolyte replacing drinks, decaffeinated tea, milk (unless sensitive) |
When to Alert Your Health Care Team About Diarrhea
Diarrhea should not be ignored since it can result in loss of fluid and nutrition that is critical while going through cancer treatment. Call your oncologist immediately if you have any one or more of the following:
Six or more loose bowel movements per day for more than 2 days in a row
No urine for 24 hours
Blood in or around the anal area, in the stool, on the toilet paper or in the toilet bowl
Fever
Swelling and/or pain in the abdomen
Not being able to drink liquids for more than 24 hours
Weight loss of 5 pounds or more since the diarrhea started
Progressive weakness, dizziness, heart palpitations
Patients with these symptoms should contact our office for assistance. . The sooner you tell your Affiliated Oncologists cancer care team, the sooner they can act to help relieve your symptoms.