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Cancer

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, for some reason, is not being reabsorbed back into the body. Sometimes diarrhea can be caused by an overflow of intestinal liquids around the stool that is lodged in the intestine (impaction). Other causes 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.

What the Patient Can Do:
  • Try a clear liquid diet (water, weak tea, apple juice, peach nectar, clear broth, popsicles, plain gelatin) 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 carbonated liquids. 
  • Eat frequent meals. Do not eat foods that are very hot or spicy.
  • Avoid greasy foods, bran, raw fruits and vegetables, caffeine, and tobacco products.
  • 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, sports drinks such as Gatorade or Powerade), an important mineral that you may lose through 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.
  • Apply a water-repellant ointment, such as A&D 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 or skin irritation as ordered by your doctor.
  • When the diarrhea starts to improve, try eating small amounts of low-fiber foods such as rice, bananas, applesauce, yogurt, mashed potatoes, low-fat cottage cheese, and dry toast.

What Caregivers Can Do:
  • See that the patient drinks about three 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. It may be better to use a prescription medicine.
  • Check the anal area for red, scaly, broken skin. If present, see section on skin sores.
  • Protect the bed and chairs from being soiled by putting waterproof pads 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 (see section on blood in stool)
  • loses five pounds 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 any liquids for 48 hours
  • has a fever of 100.5 degrees or higher, taken by mouth
  • develops a puffy or bloated abdomen
  • has been constipated for several days and begins to experience small amounts of diarrhea or oozing of fecal material which could suggest an impaction (severe constipation)