Diarrhea and Chemotherapy

The side effects of chemotherapy depend on the type of chemotherapy and the amount given. Anticipating and managing side effects can help to minimize them and provide the best possible experience for the person receiving chemotherapy.

Diarrhea and chemotherapy:

As each person's individual medical profile and diagnosis is different, so is his/her reaction to treatment. Side effects may be severe, mild, or absent. Be sure to discuss with your cancer care team any/all possible side effects of treatment before the treatment begins.

Chemotherapy can damage the cells lining the intestine, which, in turn, can cause diarrhea (watery or loose stools). Contact your physician if you have diarrhea that lasts for more than 24 hours, and/or if you have pain and cramping that accompany the diarrhea. It is important that you replace the water and nutrients you have lost. Your physician may prescribe a medication to control your symptoms, and/or, if symptoms persist, you may need fluid replacement intravenously (IV). It is possible to replace these fluids intravenously on an outpatient basis. When you are having chemotherapy, you should not take any over-the-counter medications for diarrhea without first consulting your physician.

How can I help control diarrhea?

If you have diarrhea, consider foods such as the following:

• yogurt and cottage cheese
• rice, noodles, and potatoes
• farina and cream of wheat
• eggs (cooked until the whites are solid, not fried)
• smooth peanut butter
• white bread
• canned, peeled fruits, and well-cooked vegetables
• skinned chicken or turkey, lean beef, and fish (broiled or baked, not fried)

With diarrhea, try to avoid the following types of foods:

• fatty and fried foods
• raw vegetables
• fruit seeds, skins, and stringy fibers
• vegetables high in fiber such as broccoli, corn, dried beans, cabbage, peas, and cauliflower

Some people need to avoid milk and dairy products when they have diarrhea. This is because they may not tolerate the lactose contained in these products.

In addition, consider the following information provided by the National Cancer Institute (NCI) as ways to reduce the severity of your symptoms:

• Be sure to replace all fluids that you have lost by drinking plenty of water and other fluid, such as clear broth, sports drinks such as Gatorade, or ginger ale. If you choose a carbonated beverage, let it sit for a while until it loses its carbonation.
• Eat small meals throughout the day instead of three large meals.
• Diarrhea can cause you to lose potassium. Unless your doctor has told you otherwise, eat potassium-rich foods such as bananas, oranges, potatoes, and peach and apricot nectars.
• Ask your physician if he/she advises a clear liquid diet to give your bowels time to rest. However, this kind of diet does not provide all of the nutrients you will need and should not be followed for more than three to five days.
• Choose foods that are low in fiber, such as the following:
  • white bread
  • white rice or noodles
  • creamed cereals
  • ripe bananas
  • canned or cooked fruit without skins
  • cottage cheese
  • yogurt without seeds
  • eggs
  • mashed or baked potatoes without the skin
  • pureed vegetables, chicken, or turkey without the skin,
  • fish
• Avoid high-fiber foods that may cause diarrhea and cramping. These include whole grain breads and cereals, raw vegetables, beans, nuts, seeds, popcorn, and fresh and dried fruit. Other foods that may cause cramping and diarrhea include coffee, tea with caffeine, alcohol, sweets, and fried, greasy, or highly spiced foods.
• Avoid milk and milk products, including ice cream, as diary may aggravate your symptoms.
• Keep the rectal area clean and dry, using a mild soap. If necessary, your physician may recommend an ointment or cream for irritated skin.

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