Diarrhea

This information explains what diarrhea is and how to manage it.

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About Diarrhea

Diarrhea is a loose or watery bowel movement (poop), having more bowel movements than what’s normal for you, or both. Here are the most common symptoms of diarrhea. You may have none, some, or all of these:

  • Abdominal (belly) pain and cramps
  • Gas
  • Mucus (a jelly-like substance) in your bowel movement
  • Bleeding from your rectum (a holding area for poop)
  • A fever of 100.4 °F (38 °C) or higher
  • Dehydration (not having enough water in your body)

Many people get diarrhea at some point during their cancer treatment. If you have diarrhea, talk with your healthcare provider. They’ll help you find the best way to manage it.

Infections that cause diarrhea spread person to person. The best way to prevent these infections is to wash your hands with soap and water for at least 20 seconds, especially after using the bathroom and before eating.

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Managing Diarrhea

Ask your healthcare provider about the best way to treat your diarrhea. The ways to manage diarrhea and the amount of time it takes to feel better is different for everyone. They may have suggestions that are specific to your needs. These suggestions may be different than the guidelines in this section.

Medication to treat diarrhea

Don’t take any medication to treat diarrhea without talking with your healthcare provider first. Depending on the reason you’re having diarrhea, taking medications to stop it may be harmful.

If it’s safe for you, your healthcare provider may prescribe a medication or an antibiotic (a medication that kills bacteria and other germs) to treat your diarrhea. They may also suggest an over-the-counter medication you can buy at your local pharmacy without a prescription.

Foods and liquids to include in your meals

Try to eat 6 or more small meals each day when you have diarrhea. Don’t have meals with large portions.

Follow the BRATY diet to help control your diarrhea. The BRATY diet is made up mostly of:

  • Bananas (B)
  • Rice (R)
  • Applesauce (A)
  • Toast (T)
  • Yogurt (Y)

Here are some other foods and liquids that will help you get enough nutrients (something in food that helps your body work) to manage your diarrhea.

Meat and meat substitutes

  • White-meat poultry with the skin removed (such as chicken and turkey)
  • Plain baked fish
  • Eggs
  • Tofu

Vegetables

  • Well-cooked carrots, green beans, asparagus tips, and beets
  • Baked potatoes with the skin removed (no fried potatoes)

Fruits

  • Bananas
  • Applesauce
  • Cooked or canned fruits with the skin and seeds removed (such as apples, peaches, apricots, pears, and fruit cocktail)

Starches

  • White and Italian bread, rolls, plain bagels, and English muffins
  • Saltine crackers
  • Graham crackers
  • Cold cereals (such as cornflakes, Corn ChexTM, puffed rice, Rice ChexTM, and Rice Krispies®)
  • Hot cereals (such as Cream of Rice®, Cream of Wheat®, and Farina®)
  • White rice
  • Plain pasta without heavy sauce

Dairy

  • Lactose-free milk (such as Lactaid® and Dairy Ease®)
  • Lactose-free cottage cheese and ice cream
  • Plain yogurt
  • Sorbet
  • Lactose-free supplements (such as Ensure®). A supplement is something you add to your diet to make sure you get all the nutrients you need.

Foods and liquids to avoid

High-fiber foods and liquids

Fiber is the part of your food that doesn’t get digested by your body. It’s what most of your bowel movements are made up of. Don’t eat high-fiber foods and liquids when you have diarrhea. These include:

  • Whole-grain breads and cereals
  • Bran
  • Cooked or raw gas-producing vegetables (such as lettuce, onions, garlic, cabbage, cauliflower, and broccoli)
  • Fresh and dried fruits
  • Juice with pulp (such as prune and orange juice)
  • Beans, peas, corn, and popcorn

High-fat foods

Eating high-fat foods can make your diarrhea worse. Try not to eat:

  • Butter
  • Margarine
  • Oil
  • Salad dressing

Don’t eat:

  • Fried foods
  • Gravies
  • Cream sauces
  • High-fat deli meats
  • Sausage and bacon

Foods and liquids with lactose

Lactose is a sugar that’s found in milk and milk products. When your bowels (intestines) are irritated, you may not be able to fully digest lactose. This can cause gas, stomach cramping, and diarrhea. Try not to eat foods and liquids with lactose when you have diarrhea. These include:

  • Milk (low-fat, whole, and skim)
  • Cheese
  • Cream and sour cream
  • Ice cream and sherbet

If you’re not able to avoid foods and liquids with lactose, you can take a lactase supplement (such as Lactaid) that helps you digest lactose. Take the supplement before you eat or drink any milk or milk products.

Other foods to avoid

  • Foods and liquids that have sorbitol (a sugar alcohol found in some gum and sugar-free hard candies)

Depending on the reason you’re having diarrhea, your healthcare provider will make suggestions on what you can eat and drink. They may suggest you only limit certain foods and liquids, or they may recommend a special diet.

If you’re on a special diet or have diabetes, it may be hard for you to follow these guidelines. A clinical dietitian nutritionist or a diabetes educator can work with you. Ask your healthcare provider for a referral. A referral is when your healthcare provider sends you to see another healthcare provider for more services.

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Preventing Dehydration

You’re more likely to become dehydrated when you have diarrhea. This is because diarrhea causes you to lose more fluid from your body than usual. The following things can help prevent dehydration.

  • Try to drink at least 8 to 10 (8-ounce) glasses of liquids each day. This will help you rehydrate (replace the fluid your body loses from having diarrhea). Rehydration is the most important treatment for diarrhea.
  • Drink small amounts of liquids often. This is more helpful than drinking large amounts of liquids at once.
  • If you don’t enjoy drinking water, try mixing in a small amount of fruit juice to add flavor.
  • Drink hydration fluids (such as Pedialyte® and Rehydralyte). These fluids have electrolytes, which help to balance the fluids in your body and keep you from becoming dehydrated.
  • Drink clear soups, broth, gelatin (such as Jell-O®), and Gatorade®. These liquids have salt and sugar, which can help keep you from becoming dehydrated and feeling weak.
  • Don’t drink alcohol or liquids with caffeine (such as coffee, tea, and some sodas). They can make you dehydrated.
  • If you’re not able to drink liquids, you can get them through an IV (a thin, flexible tube that puts fluids directly into your vein).
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Caring for the Skin Around Your Anus

Diarrhea may irritate the area around your anus (the opening where poop leaves your body). It can cause itching, pain, or a rash and make hemorrhoids (clumps of enlarged blood vessels in your rectum) worse. The following things can help prevent irritation.

  • Use witch hazel pads (such as TUCKS® Medicated Cooling Pads) to help lessen pain and swelling. Hold the pads against the skin around your anus. You can keep the pads in your refrigerator so they’re cool, or you can use them at room temperature.
  • Use a pain relief cream that doesn’t have steroids, such as a hemorrhoid cream with pramoxine (such as Preparation H® Maximum Strength Pain Relief Cream). Apply the cream to the skin around your anus up to 4 times a day. Apply the cream either before or after you have a bowel movement, whichever is more helpful.
  • Apply vitamin A&D cream (such as A+D® ointment) or zinc oxide cream (such as Desitin® cream) to the skin around your anus after every bowel movement. Apply it right after you dry the area to prevent rashes and soothe your skin. Don’t apply any of these creams if you’ve already applied a pain relief cream.
  • Take a sitz bath (sitting down and soaking in a warm water) after every bowel movement or as needed.
  • If you’re not able to use a sitz bath, wipe the skin around your anus with unscented baby wipes (baby wipes that don’t have a smell) after every bowel movement. Scented baby wipes can bother your skin. Dry the area with a soft towel.
  • Wear loose underwear and pants. Don’t wear thongs.
  • Try not to do any activities that may hurt the area around your anus (such as riding a bicycle, motorcycle, or horse).
  • Don’t use scented body lotion on the skin around your anus.

You can buy these items at your local pharmacy without a prescription.

Once you finish taking care of the skin around your anus, wash your hands with soap and water for at least 20 seconds. This is the best way to prevent infections that cause diarrhea from spreading person to person.

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When to Call Your Healthcare Provider

Call your healthcare provider if you have any of the following:

  • Diarrhea that doesn’t get better after you follow the guidelines in this resource
  • Diarrhea that has bright red blood in it or dark colored poop that has bloody streaks in it
  • A fever of 100.4 °F (38 °C) or higher
  • Pain or swelling in your abdomen that doesn’t feel better after you take medication
  • Fatigue (feeling more tired and weak than usual)
  • You’re not able to drink liquids without vomiting (throwing up)
  • You’re vomiting
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