Bloating and cancer treatment

It’s one thing to feel overly full after a large celebratory meal, but unfortunately, for many patients in cancer treatment, bloating doesn’t just come with a holiday, but instead is an unpleasant side effect of cancer therapy. Uncomfortable fullness after meals, or bloating, may be caused by a variety of reasons including decreased exercise due to fatigue, taking in too much air while eating or eating gas-producing foods.

Bloating also can be caused when the movement of food through the digestive tract slows as a result of cancer treatments, including gastric surgery, chemotherapy, radiation therapy or other medications. The bloating associated with chemotherapy is often referred to as “chemo belly.” Whatever the cause, the discomfort is universally unwelcome. The good news is that this is a temporary condition which will improve. In the meantime, try the following strategies to help yourself feel better:

Choose foods carefully

It’s a Catch-22. You need good nutrition to help your body recover and heal at its optimal level, but oftentimes the foods with great nutritional benefits, like some fruits and vegetables, are also likely to cause bloating. Following these guidelines may ease your tummy troubles:

• Reduce gas-producing vegetables and fruits, such as legumes, broccoli, Brussels sprouts, cabbage and asparagus. Some fruits, including prunes, apples and pears contain sorbitol, a sugar that produces excessive gas, and so these fruits should be avoided or eaten in moderation. (Sorbitol-sweetened sugar-free gum and candy can lead to excessive gas as well.)
• Choose fruits with a lower amount of fructose including berries, plums, ripe bananas and citrus (oranges, grapefruit, etc.).
• Prepare vegetables and fruits in a more digestible form, such as a pureed soup, or by juicing fruits and vegetables.
• Avoid high-fat foods that cause gas formation. These include deep-fried foods, fatty meats and foods withi large amounts of butter or shortening.
• Choose non-carbonated beverages, as the bubbles may promote gassiness. For some people, it may help to limit caffeine intake as well.
• Be careful with dairy. Chemotherapy and radiation can prevent the small intestine from producing enough of the body’s required enzyme lactase, which can lead to bloating, gassiness, cramping or diarrhea when foods with lactose are eaten. For gentler dairy choices, consider probiotic-rich foods that improve digestion, such as unsweetened yogurt and kefir, with fresh fruit or nuts added for flavor and texture.
• Balance your meals with foods less likely to cause bloating, including lean protein, (fish, chicken, lean meats), moderate healthy fats (smooth nut and seed butters, avocado) and whole grains including bread, rice, oatmeal, well-cooked barley (think soup) and well-cooked carrots, beets, green beans, squash and spinach.

Keep in mind that you don't need to avoid troublesome foods completely. Try experimenting slowly with small quantities and avoid eating too many foods that cause discomfort on the same day. For additional guidance, especially if you are experiencing other symptoms in addition to bloating, ask your medical team to order a nutrition consultation. A registered dietitian can provide personalized recommendations to help you meet your nutritional needs while managing side effects of treatment.

Strategies to reduce bloating

• Chew food slowly and try to be aware of not gulping in air along the way. Most of us have become accustomed to eating food quickly, either on the run, or even at mealtimes. The more you chew your food, the more saliva you’ll produce, and that saliva contains digestive enzymes that will help reduce gas that causes bloating. Gulping excessive air can also be reduced by avoiding drinking through straws, chewing gum or breathing through your mouth. You may also find that eating five or six smaller meals throughout the day will help relieve that overfull bloating feeling.
• Stay hydrated. Water helps to restore the sodium balance in your body and normalizes your digestive tract as well as keeping you hydrated. While everyone’s fluid needs are individual, aiming for a daily recommendation of eight, 8 ounce glasses of water can be a good place to start. However, try to avoid filling up on water right before you eat, as this can contribute to a feeling of fullness.
• Try tea. Ginger, peppermint and fennel tea are all long-honored as digestive aids and remedies. The fragrant steam may enhance your feeling of well-being with the benefit with aromatherapy.
• Exercise. Take a walk. Being upright and moving your body may help bring relief from bloating. Walking also helps to release trapped gas. It’s free, easy to do throughout the day and comes with the extra benefit of improving circulation. Walking after you eat also will help move things along in the digestive system so try to get in the habit of taking a stroll – even if it’s a short one – after every meal.
• Choose comfy clothing. We all want to fit into our favorite pair of jeans, but this is the time to cut yourself some slack. Look for clothes with forgiving waists and fabrics that don’t pinch or cling. Remember – this is a temporary state that isn’t your fault. Indulging in some comfortable clothing that helps you feel good might even help reduce your bloating as stress can affect digestion and inflammatory response.
• Use a hot water bottle or heating pad. Nurture yourself with an old-fashioned remedy that is inexpensive, convenient, easy-to-use and offers cozy comfort. Placing a hot water bottle or heating pad on your abdomen aids digestive organs, improves circulation and helps ease the gas that’s built up in your stomach. If you’ve got a compliant cat who’s willing to step in and snuggle in against your belly, that will do the trick too!