Relieving Gastrointestinal Side Effects From Chemotherapy

Constipation is difficulty having bowel movements. It can give you a stomachache or cramps, along with gas and bloating. There are many ways to manage this side effect.

Dr. Reese recommends the combination of a stool softener, to make bowel movements easier to pass, as well as a laxative, "which helps to move things along the tracks," he says. "In many cases, a low dose of a stool softener and a once-a-day laxative pill can be enough."

If constipation is severe, you may need to add two or three medicationsfor example, a combination of gentle laxatives like MiraLAX and Senokot. Most people tolerate these medications well enough to raise the dose. "You can increase to three or four, up to eight pills a day of the Senokot until you see relief," Dr. Reese says. In more severe cases, you may have to add on other medications, like Milk of Magnesia.

Also look at whether any of the medicines you take to treat your cancer or manage side effects might be causing this symptom. "Many of the anti-nausea medications can actually increase constipation. So if you’re not having nausea, stopping the anti-nausea medications can go a long way to decreasing problems with constipation," Dr. Reese says.

Ask your doctor about incorporating lifestyle changes like these, which can also help to relieve constipation:

• Eat high-fiber foods, such as apples and other fresh fruits with their skins on, dried fruits such as apricots and prunes, and whole-grain breads and cereals
• Avoid constipating foods, like cheese and eggs
• Drink more fluids, especially water and fruit juices
• Exercise every day to help digested foods move through your intestines
• Ask your doctor about taking a magnesium supplement, since low magnesium levels can cause constipation

Dealing with Diarrhea

At the other end of the GI distress spectrum is diarrhea, where you're passing loose stools. Chemotherapy, as well as other treatments and the cancer itself, can sometimes cause this side effect.

"This is something that we usually manage with over-the-counter Imodium," Dr. Reese says. "Take two pills with the first episode of diarrhea, and one pill with each subsequent episode, until it stops."

If the diarrhea is severe, your doctor may recommend that you alternate Imodium with another anti-diarrhea medication, such as Lomotil. Continue to alternate these medicines until the problem improves.

Because diarrhea can dehydrate you, drink extra water and other fluids until it resolves. You also want to replenish electrolytes like potassium and sodium. A sports drink can help. Once the diarrhea starts to improve, eat foods that are bland and easy to digest, like rice, applesauce, bananas, and dry toast. Avoid milk-based products, such as ice cream, which can sometimes make diarrhea worse. Also limit high-fiber foods, such as:

• Whole grains
• Beans and peas
• Dried fruits
• Raw fruits and vegetables

Remember to communicate any issues you’re having with the team that treats your cancer. If you have any side effects from your treatmentgastrointestinal or otherwisereport it to your doctor. Chances are there's a way to manage it, so you don't have to remain in discomfort.

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