|
Managing Diarrhea From Chemotherapy
Chemotherapy can damage healthy cells such as those that line the interior of the digestive tract.1 The result can be a disruption in the delicate fluid balance that these cells maintain. Specifically, absorption of fluid from the gastrointestinal (GI) tract back into the body is decreased, and secretion of fluid and electrolytes in the stool is increased. This causes watery bowel movements, otherwise known as diarrhea.2
The Challenge of Managing Diarrhea
Diarrhea not only is an inconvenient side effect of cancer treatment, but also can be life-threatening if not adequately managed. It may lead to:1-3
- Dehydration (a condition caused by the loss of too much water from the body)
- Electrolyte imbalance (having too many or too few electrolytes in your body, which can keep your organs from functioning properly)
- Malnutrition (not getting enough calories or nutrients such as vitamins and minerals) due to reduced absorption of nutrients
- Inflammation, pain, or bleeding as a result of increased bowel movements
At its extreme, diarrhea can cause the critical electrolytes sodium and potassium to reach dangerously low levels, known as hyponatremia and hypokalemia, respectively.4,5 The body continually regulates sodium and potassium. Too much of one can cause a reduction in the other in order to maintain levels within a narrow range. Talk to your doctor about the symptoms of sodium or potassium imbalance.
Factors That Make Diarrhea Worse
Some factors may make chemotherapy-related diarrhea worse. For example:1
- Damage to the intestines as a result of surgery or radiation may make the GI system more susceptible to irritation.
- Other medications (such as antibiotics), and some medical conditions. Talk to your doctor about how your medical condition may make diarrhea worse.
Managing Diarrhea
Diarrhea can be addressed in different ways.
Diet
Several changes in your diet will help reduce the discomfort of diarrhea:1
- Avoid foods that irritate the GI system, such as greasy, spicy, or fried foods.
- Avoid milk and dairy products because diarrhea may lead to a loss of the enzyme lactase, which breaks down lactose, the sugar found in milk, resulting in temporary lactose-intolerance.
- Because of their high-fiber content, vegetables tend to be difficult to digest and should be avoided during episodes of diarrhea. Cruciferous vegetables, such as cabbage, brussel sprouts, and broccoli, can be particularly problematic.
Your diet should be limited to simple, easy-to-digest foods, and then be expanded as the diarrhea begins to subside.1
A diet consisting of bananas, rice, applesauce, toast (called the BRAT diet), and clear liquid is a good starting point. Eventually, you can add pasta without sauce, white-meat chicken without skin, scrambled eggs, and other easily digested foods, as tolerated.1
Fluids
Staying hydrated (giving your body plenty of liquids) is very important in the management of diarrhea. You must consume enough clear liquids to make up for the volume of fluids lost due to the diarrhea. This amount is in addition to your usual daily intake.1,3
- You may need to take in three to four liters or more of fluid per day.1
- In addition to plain water, you should include fluids that
contain some sugar and salt, such as broth or Gatorade®.1,6
Replacement of fluids with plain water alone can lead to low
levels of salt or calcium in the blood. These can be life-threatening
conditions.4
Talk to your doctor about other ways to manage diarrhea.
Sometimes side effects signal a serious problem. Find out when to call your doctor about chemotherapy side effects.
Drug Therapy
To treat diarrhea, ask your healthcare provider about whether or not you will benefit from antidiarrheals.1
|
Learn more about how you can best manage other types of chemotherapy side effects.
1. Gastrointestinal complications (PDQ®)—health professional version. National Cancer Institute. Updated July 9, 2009. http://www.cancer.gov/cancertopics/pdq/supportivecare/
gastrointestinalcomplications/HealthProfessional/page1. Accessed June 4, 2010.
2. Management of chemotherapy induced diarrhoea in adults with cancer. Royal United Hospital Bath NHS Trust. Updated December 2008.
http://www.ruh.nhs.uk/about/policies/documents/clinical_policies/local/405%202006
%20Management%20of%20Chemotherapy%20Induced%20Diarrhoea.pdf.
Accessed June 4, 2010.
3. What are the possible side effects of chemotherapy? American Cancer Society website. Updated June 17, 2009. http://www.cancer.org/docroot/ETO/content/ETO_1_4X_What_Are_The
_Side_Effects_of_Chemotherapy.asp?sitearea=ETO. Accessed June 4, 2010.
4. Medline Plus medical encyclopedia—hyponatremia. National Institutes of Health website. http://www.nlm.nih.gov/medlineplus/ency/article/000394.htm. Accessed June 4, 2010.
5. Medline Plus medical encyclopedia—hypokalemia. National Institutes of Health website. http://www.nlm.nih.gov/medlineplus/ency/article/000479.htm. Accessed June 4, 2010.
6. Chemotherapy and you. National Cancer Institute. Updated May 2007. NIH Publication No. 07—7156. http://www.cancer.gov/cancertopics/chemotherapy—and—you.pdf. Accessed June 4, 2010.
Understanding Cancer –
Chemotherapy Side Effects –
Treating Cancer in Other Ways
Tracking Your Test Results –
Understanding Insurance and Tax Issues
Chemotherapy Resources and Organizations –
Register for Programs
|
 |
 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| You don't have to cope with cancer all by yourself. Get encouragement and assistance from
trained support volunteers. Sign up here. |
|
|
|
 |
| |
|
|
|
|
|
