Dealing with DiarrheaOver the past 10 years, Ivy Phillips has been treated for Breast cancer as well as Ovarian cancer. And now she’sbattling ovarian cancer again. Along the way, she’s gone through multiple rounds of chemotherapy and learned a lotabout how to deal with the side effects.“It’s a lot and it’s very taxing. But, you know, some of it is manageable, and you learn the tricks as you movealong.”-Ivy, PatientAmong the most common side effects are Gastrointestinal or GI issues, including diarrhea.“Conventional chemo kills cells that grow in the body quickly - and that’s the cancer. But the G.I. tract also hascells that turn over quickly.”-Dr. Ajai Chari, MD, OncologistDamage to those cells by treatment can lead to diarrhea. If you experience it, don’t be afraid to tell your healthcareprovider.“I’ve had patients who somehow seem embarrassed to talk about it. But we would rather know that you’re notleaving your home because you’re worried about soiling yourself rather than telling us.”- Dr. Ajai Chari, MD,OncologistThat help can come in the form of anti-diarrhea treatments available over the counter or medications in pill formthat your provider prescribes.“These are drugs that slow down the GI tract such that it would reduce the diarrhea frequency. We really wantto know - how bad is it? Is it completely liquid? Is it six to eight stools a day, or are we talking soft one to two aday. And based on that, we can recommend different things.”- Dr. Ajai Chari, MD, OncologistKeeping track of your bouts of diarrhea can help you use the medication more effectively.“I encourage people to keep a chemo calendar, where you write down when you’re taking or getting differentdrugs, and then noting down when the diarrhea seems to happen. So that if you know there’s a pattern that youtake drug X on Monday, and Tuesdays and Wednesdays are your bad days, just take the diarrhea pills on thosedays. You don’t have to wait for it to get bad.”- Dr. Ajai Chari, MD, OncologistChanging your diet may be helpful as well. Go for bland foods that are low in fiber and high in potassium, a keymineral lost during diarrhea. To remember what to eat, think “BRAT,” which stands for: Bananas, Rice, Apples andToast.“We want easy-to-digest foods that are not going to cause a lot of problems.”- Dr. Ajai Chari, MD, OncologistOther dietary tips for reducing diarrhea include: eat several small meals a day, so your body isn’t trying to handle tooPage 1 of 2This program is for informational purposes only. Publisher disclaims all guarantees regarding the accuracy, completeness,or suitability of this video for medical decision making. For all health related issues please contact your healthcare provider.HCON1002698 EN DealingWithDiarrhea.pdf© The Wellness NetworkDealing with Diarrheamuch at once. Choose foods high in probiotics or “good bacteria” such as yogurt, which may help keep digestionregular. Avoid greasy foods as well as dairy products; jellies and preserves; and desserts and candies. Also drinkeight to twelve cups of fluids a day; try a diet of clear liquids, such as water, broth, and weak tea. Avoid drinkshigh in acid - like tomato or orange juice as well as soft drinks, caffeine, and alcohol.“How frequently do you have meals throughout the day?”Working with a nutritionist can help you figure out what dietary changes are most effective for you. Dealing withthe issue early on is important because if diarrhea becomes severe or lasts a long time, you can get dehydratedor malnourished. Signs that your diarrhea may be “severe” include: six or more loose bowel movements a day –for two days in a row; blood in your stool; weight loss of five pounds after the diarrhea starts; fever; reducedurine production, or not urinating for eight or more hours; not wanting to drink liquids for a day or longer. If youexperience any of these symptoms, let your care team know. To manage the problem, they may adjust the doseor schedule of your chemotherapy. Most cases of diarrhea caused by cancer treatment are mild to moderate andtypically start to subside about three weeks after treatment ends.“These side effects are quite manageable, and we just need to work together as a team to really get thosesymptoms under control.”- Dr. Ajai Chari, MD, OncologistPage 2 of 2This program is for informational purposes only. Publisher disclaims all guarantees regarding the accuracy, completeness,or suitability of this video for medical decision making. For all health related issues please contact your healthcare provider.HCON1002698 EN DealingWithDiarrhea.pdf© The Wellness Network