Caring For The Patient With Cancer At Home (Symptom- Diarrhea)

Diarrhea is the passage of loose or watery stools three 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 infections, surgery, anxiety, side effects of chemotherapy, radiation therapy to the abdomen, or medicines, supplemental feedings containing large amounts of vitamins, minerals, sugar and electrolytes and tumor growth. Diarrhea caused by chemotherapy or radiation therapy may last for up to three weeks after treatment ends.

                                       

    What the Patient Can Do?

• Try a clear liquid diet like plain water, clear soups, strained kanjis, twirls (apple), strained wheat cracks (dalia) water, plain gelatin etc. 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.

                                                Plain water

                                                                Clear Soup

                                            Citrus Juices
                                          

                                                        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 your diarrhea worse.
• Be sure your diet includes foods that are high in potassium (bananas, potatoes, apricots, and coconut water). Potassium is an important mineral that you may lose if you have diarrhea.

• Monitor the amount and frequency of your bowel movements.
• Clean your anal area with a mild soap after each bowel movement, rinse well with warm water and pat dry.
• Take your medicines 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,peeled apples or stewed apples, yogurt or plain curd, mashed potatoes, low-fat cottage cheese and dry toast for a day or two. If diarrhea keeps getting better, start small, regular feeds.

        What Caregivers Can Do :

•  See that the patient drinks about three quarts of fluids each day.

•  Keep a record of the patient's 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. It may be better to use a prescription medicine. 
• Check the anal area for red, scaly, broken skin. Report this to your doctor.
• 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 six or more loose bowel movements per day with no improvement in two days.
• Has blood in or around anal area or in stool.
• Loses five pounds or more after the diarrhea starts.
• Has new abdominal pain or cramps for two days or more.

• Does not urinate for 12 hours or more.
• Does not drink liquids for 48 hours or more.
• Has a fever of 100.5F 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).

Reference: Caring for the Patient with Cancer at Home - a Guide for Patients and Families