How to Manage Diarrhea During Cancer Treatment
HOW TO MANAGE DIARRHEA DURING CANCER TREATMENT
Angela Martens, RD, a registered dietitian from CancerCare Manitoba answers:
When you are experiencing diarrhea, eating well can be a challenge. Diarrhea caused by cancer treatment is best managed with prescription medications. You should speak to a member of your healthcare team if you experience fever, strong abdominal pain, blood in your stool or if you have diarrhea more than three times a day. Here are some tips what you can do:
Stay hydrated
Drink 1.5 to 2 litres of liquid per day, taking small sips at room temperature. Sipping on fluids between meals may also help lessen diarrhea. See BOX 1
Replenish electrolytes, if needed
Excessive diarrhea may lower electrolytes (e.g. sodium and potassium) in your blood which may lead to dizziness. Sports drinks or a homemade electrolyte drink can help replace electrolytes. (BOX 2)
Choose foods that provide soluble fiber
Soluble fibre can help absorb fluid and thicken your stool. (BOX 1)
Consume well-tolerated foods in frequent, regular, small portions
Eat small meals because large amounts of food may trigger diarrhea. Try our meal plan. (BOX 3, 4)
BOX 1: : FLUID AND FOOD CHOICES TO MANAGE DIARRHEA
CHOOSE
- Non-caffeinated beverages, low lactose * milk or soy beverage, and “plain” foods (BOX 3)
- Drinking a broth is also good option (any fluid with water, sugar, salt)
- Foods that contain soluble fiber which may help manage diarrhea:
- Barley, oats, oat bran, chia seeds
- Cooked root vegetables, such as peeled potato, sweet potato, carrots
- Cooked green or yellow beans, asparagus tips, mushrooms
- Peeled and seedless fruits, such as apples, banana, pear, peaches, oranges, seedless melon, avocado
- Consider following a BRAT diet (banana, rice, applesauce, toast)
AVOID
- Caffeinated beverages, highly sweetened drinks, spicy or greasy foods
- Wheat bran, corn bran, whole grain breads and cereals, whole nuts, raw vegetables, popcorn, berries, grapes, dried fruit
- milk containing lactose *
* During treatment, some individuals may develop lactose intolerance which can be a temporary inability to digest lactose, a natural sugar found in some milk products. This may worsen diarrhea. Try using lactose-free products or milk alternatives such as soy beverage for a few days to see if your diarrhea improves, then re-introduce once diarrhea resolves.
BOX 2: HOMEMADE ELECTROLYTE DRINK
Mix: 360 mL orange juice (no pulp) + 600 mL water + ½ teaspoon salt
Drink: 60mL (1/4 cup) every 2 hours until diarrhea stops.
BOX 3: FOOD SUGGESTIONS TO MANAGE DIARRHEA
Scroll over the image to see snack and meal suggestions
BOX 4: SAMPLE MEAL PLAN FOR DIARRHEA
BREAKFAST
Toast (white bread) with smooth peanut butter
Yogurt with sliced banana
Orange juice no pulp*
SNACK
Pudding made with lactose-free milk
Apple juice*
LUNCH
Chicken noodle soup*
Egg sandwich (white bread, mayo)
Plain crackers
Canned fruit
SNACK
Cheese
Plain crackers
Tomato juice*
DINNER
Grilled Fish with little oil and lemon juice White rice
Cooked carrots
Apple juice*
SNACK
Lactose free milk*
Oatmeal cookies
*Contains fluid, but don’t forget to sip on additional fluids throughout the day between meals. You can dilute your juices by adding water (half juice and half water).
Enjoy this recipe
Overnight oats
A nutritious breakfast or snack for any time of day
- Preparation: 5 minutes
- 2 servings
INGREDIENTS
- ¾ cup rolled oats
- 1 tbsp honey or maple syrup (optional)
- ¾ cup whole milk or milk alternative
- 1 tbsp chia seeds
PREPARATION
Place all ingredients in a mason jar, stir and place in fridge overnight. Enjoy cold or heat the oats in the microwave. Add some liquid, if needed.
RECIPE MODIFIER TO INCREASE PROTEIN
- Add 1 tbsp of protein or skim milk powder to the milk.
- Replace milk with high protein yogurt.
- Add liquid pasteurized eggs, ground nuts or almond flour.
Nutrition facts: for ½ of recipe when prepared with whole milk: 228 calories, 7g fat, 3g saturated fat, 8g protein, 5g sugar, 5.5g fibre
MANAGING FATIGUE
Cancer-related fatigue is the most common and often the most distressing side effect experienced by people with cancer. Learn tips on how to manage fatigue.
HOW TO STAY WELL NOURISHED AND HYDRATED
Getting all of the nutrients your body needs can help you maintain your weight and strength, stay active and support your recovery
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Source:
NOURISH: The healthy gut guide part 2. Managing GI distress. By Megan Morrison, RD and Karine Rondeau, P.Dt. https://www.nourishonline.ca
For more information: UHN: Eating tips for people with diarrhea https://www.uhn.ca/PatientsFamilies/Health_Information/Health_Topics/Documents/Eating_Hints_for_People_with_Diarrhea.pdf
