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Diarrhea is the passage of loose or watery stools 3 or more
times a day with or without discomfort. It happens when the water in
the intestine is not being absorbed back into the body for some reason.
Sometimes diarrhea can be caused by an overflow of intestinal liquids
around stool that is lodged in the intestine (impaction). Other causes
can include side effects of chemotherapy, radiation therapy to the
abdomen, or medicines; infections; surgery; anxiety; supplemental
feedings that contain large amounts of vitamins, minerals, sugar, and
electrolytes; and tumor growth. Diarrhea caused by chemotherapy or
radiation therapy may last for up to 3 weeks after treatment ends.
What the patient can do
- Try a clear liquid diet (water, weak tea, apple
juice, peach nectar, clear broth, popsicles, gelatin with no solids
added) as soon as diarrhea starts or when you feel that it’s
going to start. Avoid acidic drinks, such as tomato juice, citrus
juices, and fizzy soft drinks.
- Eat frequent small meals. Do not eat
foods that are very hot
or spicy.
- Avoid greasy foods, bran, raw fruits
and
vegetables, and caffeine.
- Avoid pastries, candies, rich
desserts, jellies, preserves,
and nuts.
- Do not drink alcohol or use tobacco.
- Avoid milk or milk products if they
seem to make diarrhea
worse.
- Be sure your diet includes foods that
are high in potassium
(bananas, potatoes, apricots, and sports drinks such as
Gatorade® or Powerade®).
Potassium is an important
mineral that you may lose if you have diarrhea.
- Monitor the amount and frequency of
bowel movements.
- 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 after each bowel movement.
- Apply a water-repellent ointment, such
as A&D
Ointment® or petroleum jelly, to the
anal area.
- Sitting in a tub of warm water or a sitz bath may help
reduce
discomfort.
- Take medicine for diarrhea as
prescribed by your
doctor.
- When the diarrhea starts to improve,
try eating
small amounts of foods that are easy to digest such as rice, bananas,
applesauce, yogurt, mashed potatoes, low-fat cottage cheese, and dry
toast for a day or two. If diarrhea keeps getting better, start small
regular meals.
What caregivers can do
- See that the patient drinks about 3 quarts of
fluids each day.
- Keep a record of bowel movements to help decide when the
doctor should be called.
- Check with the doctor before using any over-the-counter
diarrhea medicine. Many of these contain compounds that are like
Aspirin, which can worsen bleeding problems. Talk to the doctor about
using a prescription medicine.
- Check the anal area for red, scaly, broken skin. If
present,
see the section on skin sores.
- Protect the bed and chairs
from being soiled by putting pads with plastic backing under the
buttocks where the patient will lie down or sit.
Call the doctor if the patient:
- has 6 or more loose bowel movements a day with
no improvement in 2 days
- has blood in or around anal area or
in stool (see section on blood in stool)
- loses 5 lbs or more
after the diarrhea starts
- has new abdominal pain or cramps for 2 days or more
- does not urinate for 12 hours or more
- does not
drink liquids for 48 hours or more
- has a fever of 100.5° F or higher, taken by mouth
- gets a puffy or swollen belly
- has been
constipated for several days and then begins to have small amounts of
diarrhea or oozing of liquid stool, which could suggest an impaction
(severe constipation)
Go to a list of symptoms to find
other problems in Caring for the
Patient with Cancer at Home: A Guide for Patients and Families.
Revised: 04/07/08
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