Cancer and Diarrhea

Diarrhea is a common side effect from certain chemotherapies, radiation treatment, medications and antibiotics. Since chemotherapy is meant to damage rapidly dividing cells, this can also include the lining of the digestive tract. As a result, fluid is not absorbed by the gastrointestinal tract as efficiently, which causes the frequent, loose, soft, or watery bowel movements associated with diarrhea.

Diarrhea can lead to dehydration, electrolyte imbalance, and malabsorption. It is important to replace fluid and electrolytes in a timely manner. If diarrhea is difficult to control or persistent, your physician may advise you to take medications to slow down your diarrhea.

 

Tips for Managing Diarrhea

  • Eat small frequent meals (5-6 times a day) instead of 3 large meals.
  • Avoid raw fruits and vegetables, whole grain bread cereal and pasta, greasy, high fat foods, and caffeine.
  • Some people who are intolerant to lactose may also need to limit dairy products.
  • Drink a minimum of 8-10 8 oz. glasses of fluid per day, water, clear beverages like broth or juices, Gatorade, or decaffeinated tea to maintain proper hydration.
  • Replace electrolytes by consuming foods rich in potassium and sodium. Potassium can be found in fruit juices and nectars, bananas, and potatoes (without skin). Sodium can be found in pretzels, crackers, bullion, and broths.
  • Consume foods high in pectin, a helpful soluble fiber, such as applesauce, baked apples, bananas, and oatmeal.
  • Use wet wipes to gently clean yourself after each bowel movement to prevent irritation, soreness, and bleeding.

Diet plays an important role in the prevention and management of diarrhea. Soluble fiber, a certain type of dietary fiber, forms a gel in the intestines and can help absorb extra fluid associated with diarrhea. Soluble fiber is found in oatmeal, barley, potato, apple, pear, banana, carrot, beans, legumes, and psyllium [i].

It is important to consume adequate fluids in order to allow the fiber to work appropriately and prevent dehydration associated with diarrhea.

 

Tips for Adding Soluble Fiber to Your Diet

  • Include oatmeal as a hot cereal for breakfast or as a snack in between meals.
  • Use quick cooked oats in recipes in replace of breadcrumb (such as meatballs and meatloaf).
  • Snack on apple or pears (peeled if necessary; skins may be easier to digest if the fruit is poached or baked), applesauce, and banana.
  • Have a minestrone soup made with beans, carrots, potato, and barley.

Let your doctor or nurse know what’s going on. Contact your MD if you are having four or more watery bowel movements in a day, your diarrhea continues for 24hrs, or you have pain, stomach cramping or bleeding from your rectum.

 

References
[i] Eldrigde B, Hamilton, K.  “Diarrhea Management” Patient Education Handout.  Management of Nutrition Impact Symptoms in Cancer and Educational Handouts.  Oncology Nutrition Dietetic Practice Group of the Academy of Nutrition and Dietetics.
Jessica Iannotta, MS, RD, CSO, CDN

Jessica is a registered dietitian and certified specialist in oncology nutrition (CSO). She studied nutrition at Cornell University and completed her dietetic internship at New York Presbyterian Weill Cornell Medical Center. She obtained her Master's degree through the University of Medicine and Dentistry of New Jersey. Jessica has worked in inpatient and outpatient oncology settings since 2001 in the North Shore-LIJ Health System. Jessica is in charge of all operations including clinical and culinary operations ranging from menu development to evidence-based website content, relationships with registered dietitians and social workers and developing processes and protocols for intake, management and outcomes analysis of patients.

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