What Helps Diarrhea?

[tips from 18 reliable sources]

We’ve collected tips on coping with diarrhea from reputable websites such as Canadian Cancer Society, National Cancer Institute, Mayo Clinic, Cancer Research UK, etc. Find out about all the ways you can cope with diarrhea caused by cancer or its treatment.

Diarrhea is an unpleasant but common side effect in people receiving treatment for cancer. Diarrhea can result in dehydration or changes in the levels of potassium and sodium in your body. Changes in these levels can be dangerous if not corrected.

Diarrhea caused by chemotherapy or radiation therapy may last for up to 3 weeks after treatment ends.

Diarrhea meds and OTC

  • Do not take an over-the-counter PeptoBismol or other anti-diarrheal drugs before speaking to your health care team. In some instances, diarrhea can be a sign of an infection or virus, and your health care team will want to test a stool sample prior to allowing you to take medication.
  • If your diarrhea is caused by radiotherapy or chemotherapy, changing your diet alone is unlikely to help. It is important to take the anti- diarrhea medicines prescribed by your doctor.
  • Keep track of the amount and frequency of bowel movements, mention your signs and symptoms to your doctor the sooner you tell your doctor, the sooner your doctor can act to help relieve your symptoms.
  • Even if it is embarrassing, Ask your doctor about medicines to prevent diarrhea. These include loperamide (Imodium) and diphenoxylate and atropine (Lomotil).
  • If your doctor gives you medication for your diarrhea, be sure you understand how to take it.
  • For severe diarrhea from chemotherapy, ask your doctor about changing the schedule or dose of chemotherapy.
  • Vitamin C – Ask your doctor if you should stop taking vitamin C temporarily.
  • Some herbal medicines and natural health products like saw palmetto, ginseng, milk thistle, plantago seed, and aloe may make your diarrhea worse.
  • Avoid medicines such as laxatives, stool softeners, and metoclopramide (Reglan). Metoclopramide is used to prevent nausea and vomiting from chemotherapy.If you take laxatives or stool softeners you will probably be told to stop taking them while you have diarrhea.
  • Some medications, like metoclopramide, domperidone and antacids with magnesium, can make your diarrhea worse. Stop taking them while you have diarrhea, unless your doctor has told you something different.

Drink

 
  • Most people who have diarrhea need to drink 8 to 12 cups of liquid every day.
  • Drink an extra cup of liquid for every watery bowel movement (poo) you have. Sports drinks are a good choice.
  • Warm or room temperature liquids may be easier to drink.
  • Keep in mind that drinking more won’t stop the diarrhea, but it will help replace fluids you are losing.
  • Clear broth, gelatin, and Pedialyte ® are good choices for most people.
  • Water-soluble fiber supplements such as pectin (e.g. Sure-jell) may help form a firmer stool. Try adding Sure-jell to hot cereals, soups, or a banana smoothie with rice milk.
  • Oral rehydration solutions – Ask your health care team about oral rehydration solutions (a mix of water, salt and sugar that keeps you hydrated)
  • If you want to drink juice, dilute it with water. Mix half juice and half water.
  • Do not eat or drink anything with artificial sweetener (like chewing gum, candy, cough drops and “diet” drinks”), when you have diarrhea. These sweeteners may make your gas and diarrhea worse.
  • Grapefruit juice should be avoided because of potential interactions with chemotherapy and other medications.
  • Warm or room temperature liquids may be easier to drink.
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Drink to help ease diarrhea

Drink water and other clear liquids to prevent dehydration. Clear liquids keep the bowels from working too hard and help prevent irritation. As soon as your diarrhea starts, switch to a diet of clear liquids, such as:

  • Water
  • Clear soda, such as ginger ale
  • Oral rehydration drinks, such as Pedialyte®
  • Apple juice
  • Apricot juice
  • cranberry juice
  • Clear broth such as chicken, vegetable, or beef
  • Clear soup
  • Ice pops / ice chips / popsicles
  • Weak herbal tea
  • Clear soup
  • Peach or apricot nectar
  • Plain gelatin
  • Electrolyte replacement drinks such as Dioralyte
  • Soy milk
  • Lactose-free milk (such as Lactaid®and Dairy Ease®)
  • Lactose-free supplements (such as Ensure®)

Drinks you should limit or avoid

  • Caffeine
  • Prune juice
  • Acidic drinks (such as tomato juice, citrus juices)
  • Fizzy soft drinks
  • Alcohol
  • Limit milk and dairy products if they make your diarrhea worse

Eating

 
  • Eat five to six small meals a day. Eat small, frequent meals and choose foods that are easy to digest. Your body may find smaller amounts easier to digest.
  • Eat low-fiber foods. As your diarrhea starts to improve, add foods low in fiber to your diet, such as bananas, eggs (poached or boiled), potatoes (mashed or baked, no butter), rice, applesauce and toast.
  • Eat foods that are high in pectin, such as applesauce, bananas, and yogurt. Pectin, a water-soluble fiber, helps reduce diarrhea.
  • Be sure your diet includes foods that are high in potassium (such as bananas, potatoes without the skin, apricots, and sports drinks like Gatorade® or Powerade®). Potassium is an important mineral that you may lose if you have diarrhea.
  • Eat foods high in protein and calories to replace the nutrients lost through diarrhea. Examples include: eggs, asparagus, fish, tofu, white bread, cheese, peas, banana, white rice, cream soups, buttermilk, halibut, noodles, tapioca, baked potato, custard, poultry, avocado, smooth peanut butter, macaroni, applesauce, yogurt and carrots.
  • Eat foods containing sodium (salt) (e.g., broths, saltines, pretzels, soups). Salt helps you retain water so you don’t become dehydrated.
  • Remove all skins, peels, membranes and seeds from fruits and vegetables.
  • Try probiotics. Found in yogurt and dietary supplements, probiotics are beneficial bacteria that may help restore normal digestion. Lactobacillus and bifidobacterium are two examples of probiotics. Check with your health care team before taking probiotics or eating foods with probiotics.
  • Don’t eat very hot foods.
  • Eat slowly, take small bites and chew food well.
  • Stay away from foods that are natural laxatives, such as prunes, prune juice, rhubarb and papaya.

Think BRAT

The BRAT or BRAT(Y) diet is a simple, gentle and effective way to ease intestinal upset that causes diarrhea. The BRAT diet (bananas, rice, applesauce, and toast) must be stopped after 72 hours, as it does not provide complete nutrition.(B) Bananas (A) Applesauce (R) Rice (T) Toast (Y) Yogurt
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Food for diarrhea

  • Most canned or cooked fruits and vegetables without seeds or skins are easy on your stomach.
  • Vegetables like cooked and peeled squash, carrots, potatoes, sweet potatoes and turnips
  • Breads and low fibre cereals like oatmeal, cold rice cereal, pasta, white rice and tapioca
  • Protein from foods like eggs, meat, chicken, yogurt and smooth peanut butter
  • Gelatin (Jell-O®)
  • Meats, such as chicken, fish, or turkey—broiled or baked, without the skin

Foods you should limit or avoid

  • Raw fruits and vegetables
  • Dried and seedy fruits, like prunes, raisins and berries
  • Spicy “HOT” foods (Mexican, Italian, Chinese, Barbecue, Pizza, etc.)
  • Fried Foods, processed meats (fried chicken, meat, hamburger, bologna, salami, etc.)
  • Preserves
  • Corn, broccoli, chickpeas, lentils, beans, cabbage, onion, garlic
  • Jellies
  • Greasy and fried meats, eggs, sausage, bacon and salami
  • Whole wheat breads, high fibre cereals and grains
  • Pastries
  • Brown rice, wild rice, quinoa
  • Gravy and rich sauces
  • Dairy products – if they seem to make diarrhea worse.
  • Foods that contain acid such as citrus fruit
  • Foods that cause gas
  • High-fat foods
  • Popcorn, nuts and seeds
  • High fibre cereals such as bran
  • chocolate

Take care of your skin

 

Diarrhea may irritate the area around your anus. It can cause itching, pain, or a rash and make hemorrhoids worse. The following things can help prevent irritation.

  • Eat five to six small meals a day. Eat small, frequent meals and choose foods that are easy to digest. Your body may find smaller amounts easier to digest.
  • Clean your anal area with a mild soap after each bowel movement, rinse well with warm water, and pat dry. Or use baby wipes to clean yourself.
  • Use unscented baby wipes instead of toilet paper to wipe yourself after you’ve been to the toilet.
  • Soothing creams – ask your doctor or nurse about soothing creams such as E45, vitamin A&D cream (such as A+D® ointment) or zinc oxide cream (such as Desitin® cream). Apply around your anus after each bowel movement. Apply it right after you dry the area.
  • Do not use things like perfume, talcum powder or dressing tape on broken skin.
  • Avoid wearing tight trousers or underwear
  • Cotton underwear will help to keep the area ventilated – nylon can make you sweat and cause even more soreness.
  • Do not use a heating pad because the skin may be very sensitive to heat, especially during chemotherapy or radiation therapy.
  • Use a pain relief cream that doesn’t contain steroids, such as a hemorrhoid cream with pramoxine (for example, Preparation H® Maximum Strength Pain Relief Cream). Apply the cream to the skin around your anus up to 4 times daily. Apply the cream either before or after having a bowel movement, whichever is more helpful.

Have warm baths

sitting in a tub of warm water or a sitz bath may help reduce anal discomfort. Do this a few times a day if necessary

  • Add 1-2 tablespoons of baking soda or 1-2 teaspoons of salt to the water.
  • Do not add bath oils or anything else to the water
  • Soak your bottom for about 10-15 minutes each time.

Outdoor

 

Sometimes diarrhea can cause an urgent need to get to a bathroom. Plan ahead so you can feel more comfortable leaving home.

  • Find the nearest bathroom before you need it when you go out.
  • Know exactly where the toilets are in the place you are going
  • Don’t go on long car, train or bus trips
  • Bring a change of clothes in case of an accident. Take spare underwear, pads, soothing creams and a plastic bag with you, just in case.
  • You can always rinse out underwear in the bathroom sink and put it in the bag to take home – no one needs to know about this.
  • Wearing a pad can help to protect your underwear and make you feel a bit safer
  • If you think an accident may happen, wear absorbent, throw-away underwear.

At Home

 
  • Protect your mattress – put a large pad or towel on your bed if you are worried about having an accident during the night
  • Leave a night light on near your bed, in the hallway and bathroom to light up where you are going so you can get to the toilet quickly

Resting

 
  •  Having diarrhea for more than a couple of days can be exhausting. Ask your family and friends to help you with things like cooking, cleaning the house, shopping, and collecting children from school. They really won’t mind so don’t be afraid to ask. It’s important that you get all the help and rest you need.
  • Try laying down 30 minutes after meals. Rest may slow down the digestive tract.
  • Walking may make your skin sore. Rest a lot and let air get to the sore areas.

Caregivers

 
  •  Having diarrhea for more than a couple of days can be exhausting.
  • See that the patient drinks about 3 quarts of fluids each day.
  • Keep a record of bowel movements to help decide when the cancer team should be called.
  • Ask before using any over-the-counter diarrhea medicine.
  • Check the anal area for red, scaly, broken skin.
  • Protect the bed and chairs from being soiled by putting pads with plastic backing under the patient.

Don’t use tobacco – it may irritate your digestive tract.

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References

1. Diarrhea: Cancer-related causes and how to cope. Mayo Clinic. 2018. Available at: mayoclinic.org. Accessed June 4, 2018.

2. Diarrhea. CancerNet. 2018. Available at: cancer.net. Accessed June 4, 2018.

3. Diarrhea. Cancerorg. 2018. Available at: cancer.org. Accessed June 4, 2018.

4. Diarrhea. National Cancer Institute. 2018. Available at: cancer.gov. Accessed June 4, 2018.

5. Diarrhea in Cancer Patients | Cancer Network. Cancernetworkcom. 2018. Available at: cancernetwork.com. Accessed June 4, 2018.

6. Diarrhea: A Side Effect of Treatment. Breastcancerorg. 2018. Available at: breastcancer.org. Accessed June 4, 2018.

7. Tips on coping with diarrhoea | Cancer in general | Cancer Research UK. Cancerresearchukorg. 2018. Available at: cancerresearchuk.org. Accessed June 4, 2018.

8. Diarrhea. Stanfordhealthcareorg. 2018. Available at: stanfordhealthcare.org. Accessed June 4, 2018.

9. Diarrhea: Managing Cancer Treatment Side Effects | CTCA. CancerCentercom. 2018. Available at: cancercenter.com. Accessed June 4, 2018.

10. Diarrhea – Canadian Cancer Society. wwwcancerca. 2018. Available at: cancer.ca. Accessed June 4, 2018.

11. Managing chemotherapy-induced diarrhea – Dana-Farber Cancer Institute | Boston, MA. Dana-farberorg. 2018. Available at: dana-farber.org. Accessed June 4, 2018.

12. Constipation & Diarrhea | Cancer Support Community. Cancersupportcommunityorg. 2018. Available at: cancersupportcommunity.org. Accessed June 4, 2018.

13. Managing Diarrhea: Chemotherapy and Prostate Cancer – UCLA Urology. Urologyuclaedu. 2018. Available at: urology.ucla.edu. Accessed June 4, 2018.

14. If you have diarrhoea – Information and support – Macmillan Cancer Support. Macmillanorguk. 2018. Available at: macmillan.org.uk. Accessed June 4, 2018.

15. Diarrhea | Memorial Sloan Kettering Cancer Center. Mskccorg. 2018. Available at: mskcc.org. Accessed June 4, 2018.

16. Tips for Managing Diarrhea after Radiation Therapy for Rectal Cancer. Oncologynutritionorg. 2018. Available at: oncologynutrition.org. Accessed June 4, 2018.

17. Diarrhea During Cancer. Virginiacancercom. 2018. Available at: virginiacancer.com. Accessed June 4, 2018.

18. Low Fiber Diet for Diarrhea | OncoLink. Oncolinkorg. 2018. Available at: oncolink.org. Accessed June 4, 2018.