Diarrhea Health Article

Treatments

Prevention

There are some measures that can prevent diarrhea. Patients who are receiving abdominal radiation therapy can be put into certain positions to minimize exposure of healthy intestines to radiation. Diarrhea caused by chemotherapy cannot be prevented; however, the administration of atropine during treatment with irinotecan may prevent diarrhea. Patients should stop taking dietary supplements, as these can cause diarrhea.

There are many dietary changes that can be made to prevent or reduce diarrhea. Foods to avoid include:

• whole grain breads and cereals
• fresh or frozen fruits (except banana)
• dried fruits
• fruit juices with pulp and prune juice
• raw vegetables
• canned onions, corn, olives, pickles, and Brussels sprouts
• fatty foods
• dried beans
• rich desserts
• milk and milk products
• alcohol and caffeinated coffee and tea
• spicy foods
• fried foods

Management

Of the utmost importance in the treatment of diarrhea is the replacement of fluids lost by frequent, watery stools. The patient should drink six to eight glasses of fluid daily, including clear broth, ginger ale (without the fizz), water, weak tea, and commercial formulas that contain sugars and minerals (electrolytes). Patients with severe diarrhea may need intravenous fluid replacement either at home or in the hospital.

Diarrhea can cause the perianal skin to become irritated and painful; therefore, it needs to be cleaned thoroughly after each bout of diarrhea. Baby wipes or a mild soap with water can be used to clean the irritated skin. The area should be patted dry and occasionally exposed to air. Taking a sitz bath (sitting in a bathtub of shallow water) with lukewarm water may relieve the discomfort. Petroleum jelly or other type of barrier cream may be used.

The patient should eat small, frequent meals. Foods and drinks should be taken at room temperature. Foods that can help control diarrhea include:

• bananas
• applesauce
• boiled white rice
• tapioca
• white bread
• plain pasta
• creamed cereals
• eggs
• potatoes (without skin; mashed or baked)
• fish
• chicken or turkey (without skin)

There are some medications that can slow down the movement of stool through the intestines and increase intestinal water absorption. The patient may need a combination of drugs and/or dose adjustments to achieve relief. A physician should be consulted before any over-the-counter antidiarrheal medications are taken. Antidiarrheal medications include:

• Atropine sulfate with diphenoxylate HCl (Lomotil)
• Codeine phosphate
• Loperimide HCl (Imodium-AD)
• Octreotide phosphate (Sandostatin)

These medications should not be used if infection as the cause of diarrhea has not been eliminated.

Patients who are experiencing diarrhea due to graft-versus-host disease will continue to take their immunosuppressant drugs. They may also be treated with corticosteroids and antidiarrheal medications.

Alternative and complementary therapies

Peppermint tea, chamomile tea, valerian capsules, or aloe vera juice may reduce cramping and intestinal spasms. An Ayurvedic physician may recommend taking equal parts of yogurt and water with fresh ginger, or a powder of beleric myrobalan fruit. Ginger capsules may relieve intestinal spasms and pain. Glutamine supplements may speed up the healing process and relieve irritated intestines.

Resources

BOOKS

Lenhard, Raymond E, Robert T. Osteen, and Ted Gansler. Clinical Oncology. American Cancer Society, 2000.

Maleskey, Gale. Nature's Medicines: from Asthma to Weight Gain, from Colds to High Cholesterol—The Most Powerful All-Natural Cures. Emmaus, PA: Rodale Press, Inc., 1999.

Somerville, Robert, ed. The Medical Advisor. Alexandria, VA:Time-Life Books, 1997.

Yarbro, Connie Henke, Michelle Goodman, Margaret Hansen Frogge, and Susan L. Groenwald, eds. Cancer Nursing, Principles and Practice, 5th ed. Sudbury, MA: Jones and Bartlett Publishers, 2000.

Yarbro, Connie Henke, Margaret Hansen Frogge, and Michelle Goodman, eds. Cancer Symptom Management, 2nd ed. Sudbury, MA: Jones and Bartlett Publishers, 1999.

PERIODICALS

Kornblau, Steven, Al B. Benson III, Robert Catalano, Richard E. Champlin, Constance Engelking, et al. "Management of Cancer Treatment—Related Diarrhea: Issues and therapeutic Strategies." Journal of Pain and Symptom Management 19, no. 2 (February 2000): 118-127.

Wadler, Scott, Al B. Benson III, Constance Engelking, Robert Catalano, Michael Field, et al. "Recommended Guidelihnes for the Treatment of Chemotherapy-Induced Diarrhea." Journal of Clinical Oncololgy 16, no. 9 (September 1998): 3169-3178.

OTHER

"What About Diarrhea?" American Cancer Society, Inc. 2000.1 July 2001 <http://www3.cancer.org/cancerinfo>

Belinda Rowland, Ph.D.