Managing Diarrhea

Diarrhea is unusually frequent and/or unusually liquid bowel movements. It may be caused by your cancer treatments, surgery on the stomach or intestines, infection, or emotional stress.

Long-term diarrhea may lead to dehydration (lack of water in the body), weight loss, and/or electrolyte imbalances, such as low levels of salt and potassium. Your body needs salt and potassium to function properly.

Helpful Foods

  • Yogurt, cottage cheese
  • Rice, noodles, or potatoes
  • Farina or cream of wheat cereal
  • Eggs (whites should be solid, avoid frying)
  • Smooth peanut butter
  • White bread
  • Canned, peeled fruits and well-cooked vegetables
  • Chicken or turkey without skin, lean beef, and broiled or baked fish

Foods to Avoid

  • Greasy, fatty, and fried foods
  • Raw vegetables
  • Skins, seeds, and stringy fibers of unpeeled fruits
  • High fiber vegetables: broccoli, corn, dried beans, cabbage, peas, and cauliflower – avoid these even if they are cooked
  • Foods high in sugar and/or fat

Helpful Hints

  • Avoid very hot or very cold foods and drinks – room temperature is best
  • Limit or avoid products that contain caffeine:
    • Many sodas: regular and diet colas, Dr. Pepper®, Sunkist® orange soda, Mountain Dew®, A&W® cream soda, etc.
    • Energy drinks such as Red Bull®
    • Coffees and teas
    • Chocolate
    • Over-the-counter medications: No-Doz®, Vivarin®, Exedrin®, Bayer Select® or Midol®, Anacin®, Goody’s®, Vanquish®, etc. (check the labels for caffeine)
    • Prescription medications: Ercaf®, Ergo-Caff®, Gotamine®, Wigraine®, Fiorinal®, NorgesicTM, Triaminicin® w/ codeine, etc.
  • Be careful with milk and dairy products because the lactose in them can make diarrhea worse
  • Sip your liquids
  • Avoid alcohol and tobacco products

The BRAT Diet

The BRAT diet has been promoted as a treatment of choice for diarrhea. While it can be useful for a day or two, staying on the diet for too long could cause a zinc deficiency. Zinc plays a key role in your immune system, growth, and skin development. You can meet your body’s zinc requirements by adding chicken, meat, fish, or dairy products back into your diet as soon as possible.

B...Bananas

R...Rice

A...Applesauce

T...Toast

Sudden, Short-term Attacks

If you get a sudden, acute attack of diarrhea, do not eat anything except clear liquids* for 12-24 hours. This will give your intestines time to rest and replace the fluids you lost. If you have this problem, let your doctor or nurse know as soon as possible.

*See the list of clear liquids in the dehydration section

Important!

Neither the BRAT diet nor a clear liquid diet meets your body’s basic needs for calories or protein. Both diets are short-term tools and should not be used for more than 1-2 days without your doctor’s knowledge.

If your diarrhea lasts longer than 24 hours, make sure your doctor is aware of your symptoms and has approved any and all treatments, diets, or other measures you are using to manage the problem.

Dehydration

Dehydration is an excessive loss of water from your body which occurs when your body loses more fluids than you take in. Dehydration may result from excessive or long term vomiting or diarrhea, a low fluid intake, bleeding, infection, illness, or as a side effect of treatment.

Dehydration from diarrhea can result in kidney failure, neurological symptoms, arthritis, and skin problems. It may also cause confusion and disorientation. Severe dehydration leads to changes in the body's chemistry called electrolyte imbalances, which may become life-threatening. People with severe diarrhea or severe vomiting should not be left alone to care for themselves.

Early signs of dehydration may be hard to notice. Stay alert and call your doctor if you experience any of the following signs and symptoms:

  • Increased thirst
  • Dry mucus membranes (inside of your mouth, nose, etc.)
  • Thick mucus or lack of saliva
  • Dry skin, or skin that keeps its tent shape after you pinch it/pull it up and then let go
  • Weakness or lightheadedness (particularly if it gets worse when you stand up)
  • Dark urine or little or no urine output

Clear Liquids

  • Bouillon or consommé
  • Clear carbonated beverages
  • Clear, fat-free broth
  • Cranberry/grape juice
  • Fruit ices (no milk or fruit pieces)
  • Fruit punch
  • Fruit-flavored drinks
  • Honey
  • Ice pops
  • Jelly
  • Plain gelatin dessert (such as Jell-O®)
  • Sports drinks (such as Gatorade®)
  • Strained citrus juice or lemonade
  • Strained vegetable broth
  • Tea
  • Water

Tips to Prevent Dehydration

  • Take medications for nausea and vomiting as prescribed by your doctor. If you are running low, ask for a refill.
  • Take at least a teaspoonful of clear liquids every minute.

Tips to Prevent Electrolyte Imbalance

Eat plenty of foods and liquids that contain sodium and potassium, because these minerals are often lost during diarrhea.

  • Sports drinks, such as Gatorade®, contain both sodium and potassium and have easily absorbable forms of carbohydrates.
  • High sodium liquids include bouillon and fat-free broth.
  • Foods high in potassium that do not cause diarrhea include bananas, peach or apricot nectars, and boiled or mashed potatoes.

The World Health Organization (WHO) has provided this easy recipe for a home-made version of a sports drink. After preparation, drink it in small, frequent sips.

Mix together:

  • 3/4 teaspoon table salt
  • 1 teaspoon baking powder
  • 1 cup orange juice
  • 1 quart or liter of water

When to Call Your Doctor

Be sure to call your doctor if you notice any of the following:

  • Vomiting
  • Fever of 100.5°F (38°C) or higher, shaking, and/or chills
  • Bloody bowel movements
  • Severe abdominal pain
  • Signs of dehydration (see dehydration section)