Diarrhea
Diarrhea is the passing of loose or watery stools three or more times a day. It may be accompanied by cramps in the abdomen and pain or discomfort in the rectum. When mild, diarrhea is an inconvenience. Left untreated, it can lead to serious problems, such as dehydration, loss of important nutrients, weight loss and fatigue.
What causes diarrhea?
Cancer-related treatments that can cause diarrhea include chemotherapy, immunotherapy, targeted therapy, radiation therapy to the pelvis, surgical removal of a part of the bowel, and Graft-versus-host disease, a side effect of bone marrow/stem cell transplantation. Cancers that affect the pancreas, colorectal cancer and neuroendocrine tumors of the gastrointestinal tract can cause diarrhea. Other causes of diarrhea include antibiotics, infection with Clostridium difficile, a bacterium also known as C. diff, inability to digest certain foods, infection with other bacteria, irritable or inflammatory bowel disease or viral infection.
When does diarrhea occur?
Treatment-related diarrhea is usually a short-term side effect that generally occurs within the first few days or weeks of treatment and usually resolves within a few weeks after the end of treatment.
How you can manage diarrhea
Before treatment, share your normal bowel regimen and if you have a history of irritable bowel syndrome (IBS). Your health care provider may start you on an anti-diarrheal medication sooner, rather than waiting for diarrhea to occur. Consult with your health care provider before taking over-the-counter medications and again if your diarrhea does not improve with them, especially if you have recently been taking antibiotics.
Following a bland diet can help prevent or lessen diarrhea. As diarrhea begins to improve, you can slowly add solid foods to your diet. Other suggestions include:
- Drink plenty of clear liquids (six to eight glasses of fluid per day) to replace fluids in your body. Try water, cranberry juice, ginger ale, clear broth, popsicles, decaffeinated tea and gelatin.
- Eat foods that are high in potassium, such as spinach and bananas.
- Avoid beverages with alcohol or caffeine, such as beer, wine, cola, coffee and tea.
- Eat bland, low-fiber foods, such as white rice, boiled chicken, noodles and bananas.
- Eat foods high in protein, calories and potassium that are easy to digest, such as eggs, baked potatoes, cooked cereals, bananas, macaroni and pasta, white toast, applesauce, apricots, crackers, pretzels and smooth peanut butter.
- Eat more frequently but in smaller amounts.
- Avoid high-fat foods, including fried or greasy foods and cream sauces.
- Avoid food that can irritate the digestive tract, such as milk products, chocolate, dried fruits, beans, popcorn, or spicy, greasy or fried food.
- To help soothe discomfort, clean the external rectal area with warm water and soap after bowel movements, soak in a warm bath or use a water-repellent cream.
When to call your health care provider
Call if you experience any of the following symptoms:
- Six or more loose bowel movements per day for more than two days in a row
- Blood in the stool, around the anal area, on the toilet paper, or in the toilet bowl
- Inability to urinate for at least 12 hours
- Signs of a fever
- Loss of five pounds or more after the diarrhea starts
- A swollen and/or painful abdomen
- Dizziness or light-headedness when moving to a standing position
Don’t be embarrassed to talk about diarrhea with your health care providers. They are well aware that you may experience it. Explain how what you’re experiencing differs from your normal bowel habits. This can help determine how proactive they want to be in prescribing over-the-counter drugs for bowel management.
