Diarrhea and Proctitis

These symptoms are common from radiation therapy to the abdomen and pelvis.  These are not the same thing, although chronic diarrhea may cause or worsen proctitis.  Diarrhea is when you have frequent, watery bowel movements.  It may be accompanied by gas and cramping.  Proctitis causes rectal irritation, pain, burning, and sometimes bleeding.  It may be associated with having small, frequent formed stools.  Your treatment may cause one, or the other, or both.  Most patients don't get these side effects until the 2nd week of treatment.  They usually go away 3-4 weeks after the treatments are over.  Chemotherapy may make the diarrhea worse or occur sooner than the radiation alone will.  These are some suggestions you can use to help.


Recommendations for Diarrhea

1.  Eat an easily digestible, low fiber diet that is high in protein and carbohydrates.  Avoid foods with seeds, nuts, or tough skins.  Minimize raw fruits and vegetables.  It is reported that adding nutmeg to food may slow down the action of the bowels.

2.  Avoid foods that often cause bowel upset in adults.  This includes milk and highly spiced food.  Yogurt and cheese generally do not cause problems and can be eaten.  Avoid any food that you know has caused you diarrhea in the past.

3.  Skip the coffee - it is a natural laxative.

4.  Avoid alcohol and tobacco.

5.  Drink plenty of fluids - at least 2-3 quarts daily.  Fluids like apple juice, grape juice, Kool-Aid, 7Up, Gatorade, and gingerale are recommended.  Sip liquids slowly.

6.  Eat small frequent meals.  Do not skip meals.

7.  If the diarrhea persists we usually recommend Imodium A/D [generic name=loperamide].  Ask your doctor or nurse how to use this.  If you are given a prescription medicine, use it as directed and be sure to let us know if it helps or not.

8.  A dietician is available at the Cancer Center.  We can schedule a consultation with her if you have specific dietary questions, requests, or needs.


Recommendations for Proctitis

1.  Keep the skin around the rectum as clean and dry as possible.  Use baby wipes, Tucks pads, or sitz baths after bowel movements as needed.

2.  Take sitz baths 3-4 times a day for comfort.  Use our sitz bath recommendations.

3.  Control diarrhea if you are having that too.  Oral medications generally do NOT help patients with proctits symptoms only and not diarrhea.

4.  Do NOT use over the counter hemorrhoidal products without asking your doctor or nurse in Radiation Oncology first.  Some of these products can make things worse.  You may use Tucks pads as frequently as you choose.  If we give you a prescription, make sure to use it as directed and let us know how it works.