RADIATION ONCOLOGY OF
Tips for Control of Diarrhea
Diarrhea can be a common side effect experienced by many people undergoing cancer treatment. It is the frequent passage of loose (unformed), watery stools and may lead to dehydration, the loss of nutrients and weight loss. You can relieve the symptoms of diarrhea by restricting what you eat and drinking plenty of fluids.
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Eat small, frequent meals to avoid overloading the stomach – do not skip meals. Drink fluids between meals rather than with meals. Chew with your mouth closed to avoid swallowing air and avoid chewing gum.
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Sip on fluids slowly and constantly throughout the day. Try to drink 8-10 cups of non-alcoholic, non-caffeinated fluids daily to replace losses. For each loose stool, drink one additional cup of liquid. Water, sports drinks, juice or clear broth work best. If you have diabetes, use sugar free beverages.
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Drink liquids cold or at room temperature - warm or hot fluids (including soups) may make diarrhea worse.
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Avoid drinks that contain caffeine such as coffee, cola or large amount of regular tea. Caffeine can worsen diarrhea.
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Avoid carbonated drinks unless you leave them open for at least 10 minutes before drinking.
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Avoid alcohol and tobacco (cigarettes, pipe or chewing tobacco).
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Milk and milk products may make diarrhea worse – limit intake to ½ cup serving or you may need to avoid these foods until the diarrhea stops. Cultured milk products such as yogurt or buttermilk may be better tolerated and help to replace the natural flora of the bowel that is lost with diarrhea.
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Sometimes, people have lactose intolerance during treatment. Try using lactaid products (dairy products which have been treated with lactase enzyme), soy based milk products or rice milk. If you have lactose intolerance, the diarrhea may improve when you use lactaid products or avoid dairy foods. If you are unable to take milk products, increase the consumption of nondairy high calcium foods.
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Avoid strong spices and herbs such as pepper and chili powder and highly seasoned foods.
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Avoid chips and snack foods that are made with “olean” (olestra).
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Limit the use of sugar-free foods, gums and candies. These foods contain sorbitol or xylitol which are “sugar alcohols” that can make diarrhea worse.
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Try Gatorade®, Pedialyte® or other “sports drinks” to replace electrolyte losses. Avoid those with more than 50 calories per serving as these contain simple sugar and can make diarrhea worse. You may also drink a glass of water with a teaspoon of salt.
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Be sure that your diet includes sodium and potassium which is lost when you have diarrhea.
High Sodium Foods High Potassium Foods
Saltine Crackers/Pretzels Apricot Nectar
Gatorade or other “sports drinks” Banana
Buttermilk Papaya
Hard Cheese as tolerated Tomato/Tomato Juice/V-8 Juice
Tomato Juices/V-8 Juices Potato
Table Salt
Broth/Bouillon/Canned Soups
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Increase the intake of foods high in soluble fiber such as oatmeal, white rice, bananas, white toast, applesauce, canned fruits such as pears and peaches, apricots, asparagus tips, barley, beets, plain pasta noodles, cream of rice, cream of wheat, grits and unsweetened graham crackers.
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Try a soupy rice mixture: take 1 cup long-cooking white rice and combine with 6-7 cups of water and 1 tablespoon of salt; cook according to package directions (approximately 40 minutes). For variety you can substitute broth for the water and omit the salt.
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Limit / Avoid insoluble fiber such as raw fruit and vegetables that have skins and peels, whole grain breads and cereals (whole wheat, rye, bran, shredded wheat, granola), nuts, seeds, popcorn, beans, lentils, peas, wild and brown rice.
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Avoid greasy and fatty foods such as fried meat, fish and poultry, French Fries, bacon, pizza, high fat snack foods like potato chips, donuts, pastries, gravies and salad dressings.
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Pectin (Sure-Jel) may help to lessen the frequency and loose consistency of stool output. Mix 1 teaspoon pectin powder with small amount of liquid and drink. Repeat three times per day.
What to Eat When you Have Diarrhea
Let The Doctor Know If You Are Experiencing:
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6 or more loose bowel movements per day with no improvement in 2 days even though you may be taking antidiarrheal medicine
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Urgent and explosive bowel movements despite bowel rest
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Nausea or vomiting
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Blood in your stool
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Losing weight
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Fever greater than 100.5 F
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Abdomen (stomach) becomes swollen or sore to the touch
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If you are not able to drink liquids for more than 2 days
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If you do not urinate for 12 hours or more
Over The Counter Medication for Management of Diarrhea
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Imodium® - 2 milligram tablets
Take 2 Imodium tablets by mouth at the first sign of loose stool. Continue to take 1 tablet every 2 to 4 hours until the diarrhea stops. You can take up to 8 tablets of Imodium per day. If you still have diarrhea after taking the 8 tablets, let the doctor know.
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Lomotil®
Lomotil works like Imodium and used to control mild diarrhea. Take 2 tablets at the first sign of loose stool. Continue to take 1 tablet every 4 to 6 hours until the diarrhea stops. You can take up 10 tablets of Lomotil per day.
Do not take any other medication for your diarrhea such as Kaopectate® or Pepto-Bismol® without your doctor's approval because these medications can mask a fever or may affect your platelet function.