Managing Eating Problems During Cancer Treatment, Part 4

by National Cancer Institute

(Page 5 of 7)

Diarrhea

Diarrhea may have several causes, including chemotherapy, radiation therapy to the abdomen, infection, food sensitivities, and emotional upset. Work with your doctor to identify the cause of your diarrhea so that it can be successfully treated.

During diarrhea, food passes quickly through the bowel before your body has a chance to absorb enough vitamins, minerals, and water. This may cause dehydration, which means that your body does not have enough water to work well. Long-term or severe diarrhea may cause problems, so contact your doctor if the diarrhea is severe or lasts for more than a couple of days. Here are some ideas for coping with diarrhea:

• Drink plenty of fluids to replenish what you lose with the diarrhea.

• Eat small amounts of food throughout the day instead of three large meals.

• Eat plenty of foods and liquids that contain sodium and potassium, two important minerals that help your body work properly. These minerals are often lost during diarrhea. Good high-sodium liquids include bouillon or fat-free broth. Foods high in potassium that don't cause diarrhea include bananas, peach and apricot nectar, and boiled or mashed potatoes. Sports drinks contain both sodium and potassium and have easily absorbable forms of carbohydrates.

• Limit foods and drinks that contain caffeine, such as coffee, some sodas, and chocolate.

• If you have a sudden, short-term attack of diarrhea, try having nothing but clear liquids for the next 12 to 14 hours. This lets your bowel rest and replaces the important fluids lost during the diarrhea. Make sure your doctor or nurse knows about this problem.

• Be careful when using milk and milk products. The lactose they contain can make diarrhea worse. Most people, though, can handle small amounts (about 1-½ cups) of milk or milk products.

Special Diets for Special Needs

When you have special needs because of your cancer or treatment, your doctor or registered dietitian may prescribe a special diet. For example, a soft diet may be best if your mouth, throat, esophagus, or stomach is sore. Or, if your treatment makes it difficult for you to digest dairy products, you may need to follow a low-lactose diet. Other special diets include a clear-liquid diet, a full-liquid diet, and a fiber-restricted diet.

Some special diets are well balanced and can be followed for long periods of time. Others, however, should be followed for only a few days because they may not provide enough nutrients for the long term. If you think you need a special diet, talk with your doctor and a registered dietitian. Together, you can work out a plan. You also should work with your doctor and dietitian if you are already on a special diet for a disease such as diabetes, kidney, or heart disease.

Lactose Intolerance

Lactose intolerance means that your body can't digest or absorb the milk sugar called lactose. Milk, other milk-based dairy products (such as cheese and ice cream), and foods to which milk has been added (such as pudding) may contain lactose.

Lactose intolerance may occur after treatment with some antibiotics, with radiation to the stomach or with any treatment that affects the digestive tract. The part of your intestines that digests lactose may not work properly during treatment. For some people, the symptoms of lactose intolerance (gas, cramps, diarrhea) disappear a few weeks or months after the treatments end or when the intestine heals. For others, a permanent change in eating habits may be needed.

If you have this problem, your doctor may advise you to follow a diet that is low in foods that contain lactose. Talk to a registered dietitian to get advice and specific tips about how to follow a low-lactose diet. Your supermarket should carry milk and other products that have been modified to reduce or eliminate the lactose. You can also make your own low-lactose or lactose free foods. Here's a simple recipe for a lactose-free pudding: Lactose-Free Double Chocolate Pudding).

Constipation

Some anticancer drugs and other drugs, such as pain medications, may cause constipation. This problem also can occur if your diet lacks enough fluid or fiber, or if you've been in bed for a long time. Here are some suggestions for preventing and treating constipation:

Drink plenty of liquids - at least eight 8-ounce glasses every day. This will help to keep your stools soft. Another way to think about fluids is to try to drink at least ½ oz. per pound of your body weight.

Have a hot drink about one-half hour before your usual time for a bowel movement.

Check with your doctor to see if you can increase the fiber in your diet (there are certain types of cancer for which a high-fiber diet is not recommended). If you can, try foods such as whole-grain breads and cereals, dried fruits, wheat bran, wheat germ; fresh fruits and vegetables; dried beans and peas. Eat the skin on potatoes. Make sure you also drink plenty of fluids to help the fiber work. Here's is an easy recipe that might help relieve constipation: Apple/Prune Sauce.

Get some exercise every day. Talk to your doctors or a physical therapist about the amount and type of exercise that's right for you.

If these suggestions don't work, ask your doctor about medicine to ease constipation. Be sure to check with your doctor before taking any laxatives or stool softeners.

Fatigue and Depression

All the methods of treating cancer treatment are powerful. Treatment may go on for weeks or months. It may even cause more illness or discomfort than the initial disease. Many patients say they feel exhausted and depressed, and unable to concentrate. Fatigue during cancer treatment can be related to a number of causes: not eating, inactivity, low blood counts, depression, poor sleep, and side effects of medicine. It is important for you to raise the issue with your health care team if you are having fatigue. Together, you can decide what is causing the problem, since many of the causes can be treated.

Fatigue and depression aren't eating problems in and of themselves, but they can affect your interest in food and your ability to shop and prepare healthy meals. Here are some suggestions that may help:

• Talk about your feelings and your fears. Being open about your emotions can make them seem more manageable. Consider talking with your nurse or social worker, who can help you find ways to lessen your worries and fears.

• Become familiar with your treatment, possible side effects, and ways of coping. Being knowledgeable and acting on that knowledge will help you feel more in control. Don't be afraid to talk with your doctor and ask questions.

• Make sure you get enough rest.

• try easier or shorter versions of your usual activities; don't push yourself to do more than you can manage.

• Save your favorite foods for times that aren't associated with treatment sessions. That way, they won't be linked to an uncomfortable or distressing event.

• Take short walks or get regular exercise, if possible. Some people find this helps to lessen their fatigue and raise their spirits.

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