Prevention and Management of Diarrhoea

There are many causes of diarrhoea in patients undergoing treatment for cancer, and it is essential that the appropriate cause is identified by your doctor in order that the correct treatment is undertaken promptly. 

Severe diarrhoea: 
If any of these features are present you should cease any chemotherapy medication and seek urgent medical advice:

• More than 4-6 bowel motions per day
• Bowel motions occurring during normal sleeping hours
• Presence of blood or mucus in the motion
• Associated cramping abdominal pain
• Associated nausea and vomiting
• Associated severe mouth soreness and/or ulceration
• Dehydration (dry tongue, excessive thirst, loss of skin elasticity)

Mild diarrhoea: 
Proceed as follows:

• Encourage clear oral fluids, up to 2 litres per day or more, including clear soups, flat soft drinks, cordials, weak tea.
• Bland diet until the symptoms have resolved for 24-48 hrs. Mashed banana, rice bubbles, skim milk, jelly, blancmange, vegemite toast, steamed fish, boiled rice, clear soups, mashed potato, low-fat ice-cream.  The BRAT diet (Bananas, rice, apple sauce, toast). 
• Use inhibitors of bowel contraction like loperamide (Lomotil) or Imodium, 1-2 tablets 6th hourly after bowel movements. In more severe cases your doctor may prescribe codeine phosphate, 30 mg tablets, 1-2 tablets 4th hourly as required.
• Seek medical advice about routine daily medications, but mostly these are OK. Avoid arthritis medication

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