Strategies for managing diarrhea after radiotherapy for rectal cancer


Strategies for managing diarrhea after radiotherapy for rectal cancer including fruit and raw vegetables


Have you got diet recommendations for somebody who has diarrhea after radiotherapy for rectal cancer?


Chronic radiation enteritis may be the technical term for that lengthy-term damage that may result after radiotherapy for rectal cancer. It can result in chronic diarrhea, incontinence, and bowel emergency. This will happen after management of other cancers that need radiotherapy to the stomach area too. These negative effects can happen several weeks, or perhaps years, after treatments are completed.

The next suggestions will help you manage chronic diarrhea:

  • If this sounds like a brand new symptom, inform your physician about this. Your physician might help determine whether a treatable medical problem is adding towards the diarrhea, and prescribe medications to handle it, if appropriate.

  • Ask your physician to check on you for "C. diff" (Clostridium difficile) infection. C. diff is definitely an overgrowth of ordinary GI bacteria, and may cause severe loose stools and abdominal cramping.

  • Drink a minimum of three quarts (12 cups) of liquid every day to avoid lack of fluids. Drink fluids at 70 degrees and also to sip them gradually during the day. Avoid consuming vast amounts at the same time, and sugary beverages for example juice and regular soda. These may worsen diarrhea. Try plain broth or bouillon, Gatorade, decaffeinated coffee, decaffeinated tea and water. Avoid alcohol and caffeine.

  • Eat small, frequent snacks and meals to prevent giving your digestive system an excessive amount of food previously. Lie lower soon after eating.

  • Have a detailed food record of your food intake and drink. The meals that create signs and symptoms will vary for each individual. Record how and what expensive is eaten, whether foods are home- made or from the restaurant, food temperature, and time. Include specific information regarding the signs and symptoms you have. Discuss the meals and symptom diary together with your Registered Dietitian (RD), who will help you figure out what triggers signs and symptoms. It might take several days to recognize patterns, so have patience!

  • Review all complementary and alternative therapies you use, for example special teas, vitamins, minerals, herbal medicines, along with other nutrients, together with your RD. Some herbs and nutritional supplements may cause diarrhea.

  • Discuss diarrhea medication options together with your physician. Imodium or any other anti-diarrheal medications may permit a less restrictive with diet.

  • Supplemental dieting . with psyllium, guar gum, inulin, or any other dietary fiber product as quickly as possible. If you’re able to, give a fiber supplement when you start radiotherapy. Start with one dose each day, per package instructions. Increase to 3 doses daily, spread during the day, as tolerated. Take this throughout treatment.

  • Change just one facet of your treatment at any given time. For instance, improve your diarrhea medication or the foods you eat, although not both at the same time. Where you can evaluate the things that work and just what does not.

  • Eat dry, salty foods, for example saltine crackers or dry toast.

  • Avoid hard-to-digest foods, for example popcorn, peas, corn, raw vegetables, and &ldquogassy&rdquo vegetables within the cruciferous and allium vegetable families. Including broccoli, cauliflower, cabbage, The city sprouts, kale, chard, onions, garlic clove, and leeks.

  • Avoid spicy foods when they worsen your diarrhea.

  • Avoid sugar-free foods and gum, and chocolate created using sugar alcohols, for example sorbitol, mannitol, and xylitol. Sugar alcohols can worsen diarrhea. Also avoid tobacco (cigarettes, pipe or eating tobacco), which could aggravate diarrhea.

  • Avoid greasy, fatty and foods that are fried, for example Fried potatoes, bacon, sausage, pizza, cheese, pastries, snack chips, gravies, high-fat sauces and bandages.

  • Eat yogurt with live active cultures or drink buttermilk or kefir. Strive for 4-8 ounces daily. Use other milk products only when you&rsquore taking lactase tablets to assist digestion. Try non-dairy milk, for example soy, grain, or almond, instead of cow&rsquos milk.

  • Eat more foods with dietary fiber, including oatmeal or oat bran, bananas, applesauce, and canned peaches and pears. Beans are full of dietary fiber, but could cause gas and worsen signs and symptoms. Avoid these whenever possible.

  • Avoid foods with insoluble fiber, including fruit and raw vegetables, and wholegrain breads and cereals. Eat correctly-cooked, peeled vegetables and fruit or attempt to add these to soups or smoothies. This breaks lower the insoluble fiber, which makes it simpler to digest.

  • Try Grain Congee, a soupy grain mixture. Combine 1 cup lengthy or short-grain White-colored grain with 6-7 glasses of water and something teaspoon of salt provide a boil, then simmer til you have a sticky, soupy mixture (usually ~ 40 minutes). Sip and eat mixture. Broth can be utilized rather water.

  • Ask your dietitian should you prefer a mineral and vitamin supplement to make up for malabsorption because of diarrhea. A chewable product, with 100% from the daily value (DV) for many minerals and vitamins could be taken two times daily. As diarrhea improves, change to once daily dosing.

  • Ask your physician or dietitian to buy bloodstream tests for b12 and fat-soluble vitamins. You may want to give a stool sample, too, so that you can be looked into for bile salt malabsorption.

  • Ask your physician or dietitian about testing for undiagnosed coeliac disease (gluten intolerance). You have to consume a 100% gluten-free diet to handle coeliac disease if you’re identified as having this problem. Seek counseling from your RD that will help you design a proper, well-balanced, gluten- free diet.

    The initial question and answer were generously donated by Diana Dyer, MS, RD a cancer survivor, registered dietitian, organic garlic clove player, and also the author of "A Dietitian’s Cancer Story: Information & Inspiration for Recovery & Healing from the 3-time Cancer Survivor.&rdquo

    Question and Answer updated by Daria Pori, RD, with respect to ON DPG

    Page Updated: April 2013


    A patient's experience with rectal cancer and treatment