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Diarrhea

Diarrhea is defined as more than two loose or watery stools ("poop"), per day

Diarrhea - Patient Handout

  • Diarrhea is defined as more than two loose or watery stools ("poop"), per day
  • Diarrhea is the  opposite of constipation  (hard or infrequent stools
  • Diarrhea can be "acute" (short-lasting) or "chronic" (long-lasting)
  • Diarrhea can be caused by infections, disease (e.g. diabetes, celiac disease), cancer,  surgery, medications (e.g. antibiotics, non-steroidal anti-inflammatory drugs like celecoxib (Celebrex) , ibuprofen (Advil or Motrin etc.), and naprosyn (Aleve)), herbal remedies, anxiety, or stress
  • Diarrhea is a common side effect of cancer treatment, such as radiation near the bowels.  Diarrhea may also be caused by chemotherapy.

It is very important to manage diarrhea, as it can lead to dehydration, depletion of body salts, weakness, weight loss, skin soreness, poor nutrition as well as delays in your radiation or chemotherapy treatments.

 

Diarrhea may start at anytime after your cancer treatment begins.  Follow the specific instructions given to you by your health care team regarding what to do if you develop diarrhea. 
team regarding what to do if you develop diarrhea.

You need to learn strategies for controlling diarrhea, and you need to learn when you should get in touch with your health care team.


In addition, let your health care team know immediately if:


  • Your stools ("poop") have blood or mucus
  • You have watery stools more than twice a day
  • You have a temperature of 100.5F (38◦C) or greater
  • You have very painful cramping and /or very painful stomach (abdominal) pain
  • You are throwing up (vomiting) a lot and cannot eat or drink without throwing up
  • You are extremely thirsty
  • You become dizzy and weak
  • You notice your urine ("pee") becoming darker yellow in colour, or even brown
  • You develop pain in your upper right abdomen, under your ribs

People with severe dehydration may need to receive intravenous (through a vein) fluids.


Watery stools may be diarrhea or may actually be a sign of constipation. If you are having watery stools, you may need to be examined for a fecal impaction (a large lump of dry, hard stool that is stuck in your rectum). People sometimes mistake watery stools for diarrhea and take anti-diarrhea medications. This only makes the problem worse.

 
  • If you have to stay in bed, use a bedside commode (portable toilet) when possibl
  • Keep a record of your bowel movements ("poops") and what you eat
  • It is very important to stay well-hydrated. Talk to your health care team about how much, and what type of fluids you should be drinking.
  • Avoid foods that make your diarrhea worse (such as foods high in fibre, fatty foods, hot peppers, drinks with caffeine, and alcohol)
  • Keep a list of foods that cause you more problems and try to avoid them
  • Eating can often trigger a bowel movement, so schedule your meals to allow enough time to move your bowels (go "poop") before planned activities

To protect your skin, keep the anal area clean with soap and water, or a special cleanser if the skin is broken down. Ask your nurse if you do not know what product to use for this. You can also take sitz baths (warm, shallow baths) to soothe the area.


Antidiarrheal Medications

Medications are available by prescription through your oncologist, family doctor, or over the counter at a pharmacy. Tell your health care team if you are considering taking medication for diarrhea so they can make sure it is not caused by  an infection first.


Food Ideas to help with Diarrhea during Chemotherapy

You may find the following nutrition tips helpful:


  • Stay well-hydrated  drink a variety of fluids daily to prevent dehydration. It may help to sip fluids slowly. Examples of fluids are: water, juice, liquid nutritional drinks such as Ensure®, sports drinks, soups and herbal tea. Limit caffeine or drinks that contain alcohol.
  • Eat small, frequent meals and snacks. Try to eat every 2-3 hours.
  • Limit high fibre foods such as whole grain breads and cereals with bran, nuts and seeds.
  • Remove skins, seeds and membranes from fruits and vegetables.
  • Limit corn, broccoli, beans, peas, green leafy vegetables, prunes, berries, dried fruit, beans (baked, kidney), chickpeas and lentils.
  • Avoid deep fried, greasy foods.
  • If you have severe diarrhea, try avoiding milk and milk products. Lactaid® milk or milk substitutes such as soy beverages may be better tolerated.
  • Once the diarrhea is resolved, re-introduce the foods you have eliminated one at a time.

If your symptoms are not well-controlled after following the above guidelines, if you are losing weight and your appetite is decreased, ask to see a dietitian.

 
 

BCCA library recommended websites: Constipation and Diarrhea Websites


BCCA pamphlets: Nutrition Handouts for Managing Eating Difficulties


Symptom management guidelines: Diarrhea

Revised October 2014

SOURCE: Diarrhea ( )
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