DIARRHEA
What is diarrhea?
Diarrhea is defined as more than two loose or watery stools (bowel movements) per day. Cancer treatments such as radiation or chemotherapy can cause diarrhea. These loose or watery stools may start soon after treatment. Diarrhea may be delayed for two weeks after treatment begins. If left untreated, diarrhea can cause weakness, weight loss, skin problems, fluid loss, and poor nutrition.
How do people describe diarrhea?
People usually use terms like "loose" and "watery" stools accompanied by cramping, abdominal pain, bloating or nausea. They describe the number
of times they have to use the bathroom within a period of time. They may express fear of not making it to the bathroom on time.
Diarrhea can be mild (a few stools per day) to severe (12 or more stools
per day). Skin irritation and soreness around the rectum can also result.
What causes diarrhea?
Treatments for cancer can interfere with the normal bowel function,
increasing bowel activity, or by irritating the lining of the bowel.
How do people cope with diarrhea?
Here are some tips people have found helpful:
Try foods such as bananas, rice or oat, applesauce, graham crackers, dry toast, crackers, eggs, poultry or baked potatoes. Smooth peanut butter can be used.
Avoid eating foods high in fiber, fatty foods, spicy foods, rich desserts, gas producing (such as beans, raw vegetables, corn, cauliflower and broccoli) and others that increase bowel movements or gas such as hot peppers, drinks with caffeine and alcohol. (No bran, no wheat)
Follow a low fiber/low roughage diet.
Try smaller, more frequent meals or snacks.
Increase your fluid intake to 8 (8oz.) glasses of water or other non-caffeinated drinks per day-clear fluids.
Replace lost fluids with nonfat broth, soup, orange juice and sports drinks.
When having diarrhea, drink less fluid with your meals. Drink more fluid between meals, and avoid hot liquids.
Avoid caffeine and colas.
Use over-the-counter Imodium as directed on the box (unless told not to do so by your doctor).
If over-the-counter medicines dont work, contact your doctor or nurse to prescribe something that will work.
Do not apply Vaseline to rectal area if you are having radiation.
Keep track of number of stools in 24 hours.
Avoid nuts or dried fruits.
Avoid milk products until the diarrhea subsides.
What can family members and friends do to help me with my
diarrhea?
Purchase foods to help decrease diarrhea as listed above.
Ask family members and friends to remind you to take your over-the-counter medicines as directed on the box to relieve diarrhea.
Prepare meals with low fiber and foods listed above.
Ask family members and friends to offer you fluids and broth throughout the day.
Ask family members and friends to assist in locating restrooms when outside your normal environment.
How can I talk to my family members and friends about my
diarrhea?
Request privacy to discuss your concerns.
Try to describe how the diarrhea makes you feel and express your concerns.
Tell them if you are having any symptoms listed below.
What should I report to my doctor or nurse?
Bloody or black, tarry looking stools.
Spike of fever greater than 100.4º F associated with diarrhea.
If you cannot eat of drink for more than 24 hours.
Diarrhea that continues for more than 3 days.
Know the following information when calling your doctor or nurse:
a) Your normal bowel pattern
b) Loss of more than 2 pounds per day.
c) Color, consistency and number of stools in the last 24 hours.
d) How much food and fluid youve taken in the last 1-2 days.
e) Medicines youve taken in the last 2-3 days.
f) How much weight youve lost, other history of bowel problems.
g) What makes the diarrhea worse?
Where can I get more information?
Contact the American Cancer Society at: 1-800-ACS-2345 or on the Internet at: http://www.cancer.org.
Contact the National Cancer Institute at: 1-800-4-CANCER or visit on the Internet at: http://www.cancer.gov/cancerinfo/. Click on Coping with Cancer then Side Effects then click on Gastrointestinal Complications.
Contact the National Institutes for Health on the Internet at: http://www.nlm.nih.gov/medlineplus. Click on Diarrhea.
Visit the Family Care Research Program on the Internet at: http://www.cancercare.msu.edu.
National Coalition for Cancer Survivorship: Diarrhea at: http://www.canceradvocacy.org. Click on Essential Care.
References:
Postgraduate Medicine Online: Patient Notes (2002). Volume III, (I), accessed on the Internet at: http://www.postgradmed.com/issues.
Engelking, C. (2003). Diarrhea. In C.H. Yarbro, M.H. Frogge, & M. Goodman (Eds.), Cancer symptom management, 3rd Ed. (pp. 528-558). Boston: Jones and Bartlett.
National Cancer Institute at: http://www.cancer.gov/cancerinfo/. Click on Coping with Cancer then Side Effects then click on Gastrointestinal Complications.
