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How to manage radiation-induced diarrhea?

zsazsa1
Posts: 290
Joined: Oct 2018

Well, it's begun, and I can only assume it's going to get worse.  I'm trying to eat white rice, white potato without the skin, and meat/eggs.  Any other recommendations for what I can/cannot eat?  I already know that I should avoid fiber.

Sallythatgirl2
Posts: 1
Joined: Apr 2019

Oh yeah I am dealing with this right now. Everything is a challenge and I learned the fiber thing by accident. I eat rice, potatoes,toast,crackers,bagels,ripe bananas,sugar free jello. I have 2 weeks to go .I wish you well.

CheeseQueen57's picture
CheeseQueen57
Posts: 781
Joined: Feb 2016

I started taking Culturelle about a week before starting my heavy duty radiation and never had diarrhea.  Never altered my diet. But had bad nausea until I got the meds adjusted. Good luck. 

zsazsa1
Posts: 290
Joined: Oct 2018

Welcome to the boards, Sally.  Want to tell us a little about yourself and your journey?

MAbound
Posts: 829
Joined: Jun 2016

When I started having diarrhea as a late occuring side-effect of radiation I was advised to take Benefiber and favor foods with soluble fiber over insoluble.  Foods that are a good source of pectin also help. Here are two sources:

https://www.healthline.com/nutrition/foods-high-in-soluble-fiber

https://www.livestrong.com/article/289067-list-of-foods-high-in-pectin/

I had mild nausea with the diarrhea, too, and sometimes all I could eat for dinner was green beans or oatmeal. I dealt with the diarrhea for over 6 months, but eating this stuff helped to make it less watery and gave me a chance to make it to the bathroom. I was pretty much home bound while it was going on, so my sympathies. Hope this helps.

CQ is right about the probiotic.

Lou Ann always advocated for a LO-FODMAP diet, so you might look into that, too.

cmb's picture
cmb
Posts: 341
Joined: Jan 2018

I have diarrhea at the best of times so things were much worse during chemo and radiation. I did end up following the low fiber, bland diet that the radiation nurse recommended. It was very boring but it worked for me. I posted a copy of this diet in a post last year. See https://csn.cancer.org/node/314626

zsazsa1
Posts: 290
Joined: Oct 2018

Thanks.  I just took a look at it.  I can do that.  I just hope it helps.  I have only gotten through about ten of a planned 28 treatments so far!  I don't know how I'm gonna make it!  The worst is that I have to have a full bladder and an empty rectum for treatment - which is very hard to achieve, when I'm having such bad cramping from diarrhea.  I'm thinking that maybe I just won't eat until after radiation treatment each day.

suzycruise76's picture
suzycruise76
Posts: 62
Joined: Mar 2019

Zsa Zsa,oh,how I feel for you!I just finished my chemo-radiation,which lasted for 5 weeks,5 days a week,weekends off. I had a similar dilemma to yours,but a bit more complicated:my chemo consisted of pills of Xeloda,which I needed to take at home twice a day,12 hours apart. I had chosen 9AM and 9PM. I HAD to eat 30 minuts prior to swallowing the pills. My radiation had been scheduled every day around noon. I had daily diarrhea,thankfully not watery till the last week.

But there was still a problem:I would had loved NOT to eat before going to the hospital for radiation,which way I could had prevented bouts of diarrhea...but I must had some food for Xeloda. 

When I was done with the pills,I had to make sure to have my bladder full...plus I had been taking public transportation to the hospital;now: being worried about having diarrhea and holding my bladder full,and being on time for my appointment it has been stressful as hell!

I managed by some miracle all of those 25 days without having an embarrasing accident.... Yesterday was my first day of freedom from it!!!

It is only first part of my cancer journey;there are some tests and many appointments waiting for me,and later a colon tumor surgery.Who knows,what will happened after that?

Zsa Zsa,I wish you to get through this difficult stage and every other treatments that are waiting for you!

Suzy

 

zsazsa1
Posts: 290
Joined: Oct 2018

I cannot imagine how I would have done this had I been forced to take public transportation to my treatment appointments all through this.  I feel for you, Suzy.

Jairoldi's picture
Jairoldi
Posts: 197
Joined: May 2017

I tried not to eat or not to eat too much before radiation each day. I used Metamucil and probiotics at the suggestion of my radiologist. I also went straight

home. Fortunately I didn' have to work while undergoing treatment. I used long term disability and did what work I could from home on the computer.

cmb's picture
cmb
Posts: 341
Joined: Jan 2018

I had my radiation treatments at 9:15 in the morning. I didn't eat or drink coffee (also a diarrhea catalyst for me) until after I had the radiation treatment. 

zsazsa1
Posts: 290
Joined: Oct 2018

Now I'm reading about radiation-induced enteritis, both acute and chronic.  Did anyone have any medication prescribed during treatment to try to protect the bowel cells from radiation injury?  I just don't see how that wouldn't also protect the cancer cells, too, which would undermine the efficacy of treatmtent.

Soup52's picture
Soup52
Posts: 894
Joined: Jan 2016

I never had diarea with radiation. Idolized the diet too closely and had constipation which:I had a little of before and continue to have.

barnyardgal
Posts: 197
Joined: Oct 2017

I had diarrhea. It wasn't too bad, but I took Imodium and probiotics. I did go to work most of the time thru radiation and I was always a little worried since there were only public restooms but fortunately the Imodium worked pretty well. I wasn't thrilled about diarrhea but for me it seemed a breeze compared to the chemo induced constipation. The only thing I ended up with is a small hemorrhoid. 

zsazsa1
Posts: 290
Joined: Oct 2018

Had a discussion with the radiation oncologist yesterday.  He said that the treatment I've had thus far (about 12 of the planned 28 treatments) will have been for naught unless I complete it - that there is no efficacy unless I get to ever 4000 (plan is 4500 to nodes, 5000 to vagina).  I don't know what to do.  He said it's unusual to see diarrhea this badly this early, and he couldn't say if it didn't forbode long term diarrhea.  I'm going to add in the probiotic.  I'm already basically eating only rice, white bread, meat.

jan9wils's picture
jan9wils
Posts: 50
Joined: Mar 2017

zsazsa1 I too had horrible diarrhea throughout my radiation treatments. Pretty much right from the start. I was told to eat "white" which I did but worried about nutrition. I took lomotil several times a day, a probiotic, and ate a peanut butter sandwich on white bread for lunch. I used a water bottle to clean myself. I was teaching and I saved most of my eating for evenings so I wouldn't embarass myself at work. I completed all of my treatments but the diarrhea persisted for months afterward. I went to a homeopathic pharmacist and he changed my probiotic and recommended B12 and B6 in addition to a multivitamin. Voila! almost overnight I improved. I was excited to eat salads again! I sure hope you can get some relief.

DM_K's picture
DM_K
Posts: 46
Joined: Mar 2018

I found if I ate before radiation and took zofran (which also has a constipation agent) before my treatment it really helped.  Sometimes I needed to take Immodium too and towards the middle of the treatment I had to take lomotil a few times only, it's pretty strong.

 

Radiation side effects were much more difficult for me than chemo but it's still doable.

zsazsa1
Posts: 290
Joined: Oct 2018

So I did a little reading about probiotics, and in mice it was found that starting the probiotic BEFORE radiation tx seemed to help prevent the damage.  I'm gonna try the Culturelle now, but I wish I had known this!  Also, Jan, what probiotic did the naturopath switch you to?

CheeseQueen57's picture
CheeseQueen57
Posts: 781
Joined: Feb 2016

you didn’t find the Culturelle info on here because it was pretty widespread when I was going into radiation. And I swear, I had no diarrhea. 

zsazsa1
Posts: 290
Joined: Oct 2018

I"m starting it now, but boy do I wish I had known this beforehand!  According to the mouse study, the probiotic helped if begun before radiation, but not afterwards.  I just had no idea.

jan9wils's picture
jan9wils
Posts: 50
Joined: Mar 2017

The name of the probiotic is UltraFloa Balance by Metagenics taken twice a day. 

NoTimeForCancer's picture
NoTimeForCancer
Posts: 2544
Joined: Mar 2013

I gave details on a study that was shared with me pre-radtation: https://csn.cancer.org/node/319319

There should be more in the Uterine threads. 

here is the "Let's talk about radiation thread" as we all had a good chat here:  https://csn.cancer.org/node/296985

zsazsa1
Posts: 290
Joined: Oct 2018

CheeseQueen57, I think the Culturelle is working!!!!! I started it today.  For the past few days, I've had very frequent horrible diarrhea - the only way to slow it was to not eat at all.  Now it seems to have stopped!  I ate Chow Fon rice noodles with beef for dinner, and four hours later, nothing yet!  Thank you.

zsazsa1
Posts: 290
Joined: Oct 2018

The Culturelle definitely is helping, much less diarrhea, but it is still virtually all diarrhea.  At least I can eat.  Jan, I will order the Ultra probiotic you used.  Until then, I'll continue with the Culturelle twice a day.  

And No Time, thanks for the study.  I just hope it's not too late for the probiotics to help me.

EJCB1
Posts: 1
Joined: Apr 2019

I also had terrible diarrhea for a few weeks during treatment. The nutritionist at my cancer center recommended Banatrol... banana flakes... to add bulk. Seemed to help, but I couldn't always stomach it. Also recommended peanut butter and marshmallow (couldn't stomach that either, so did peanut butter and jelly). The diarrhea got the point where I had to use adult diapers for a while. But at some point, it seemed to peak and then get better. Hope yours also lets up! Hang in there!! 

Donna Faye's picture
Donna Faye
Posts: 214
Joined: Jan 2017

I was taking up to 6 Immodium a day from the 3rd week on, and am never w/o it even today a year out. I found the liquid to be better to take and seemed to act quickly. I still have 3+ BMs a day so if have a special day planned, take the Immodium in the morning after b'fast. so I can have a nice day w/o worry. I can eat almost anything now but I do pay the piper if it is too rich or spicy. I do take a probiotic.  

zsazsa1
Posts: 290
Joined: Oct 2018

Still with diarrhea.  What I do is I take a Culturelle when I get home from radiation (I've got 9 treatments left to go), and I don't eat until after that.  I have crampy diarrhea, mostly very very soft or liquid, several times a day.  But it's a lot better than when it began - then I was passing stool constantly, even to the point of a bit of rectal prolapse.  

I am hoping that it will get better after the radiation treatment is over.  I was always very constipated, so I was kind of hoping that I'd be at worst just a "normal" once or twice a day person after radiation.  But even if I am left with chronic diarrhea at this level, I'll manage, as long as the UPSC/clear cell doesn't come back!

zsazsa1
Posts: 290
Joined: Oct 2018

I'm doing a lot better, finally, almost a month after external beam radiation was completed.  If I eat only protein (meat, fish, poultry, eggs, etc) and rice, white bread, I'm pretty good.  I'm cautiously adding in melon, banana, things that are considered constipating.  I avoid all fiber.  Hopefully, it will only continue to improve, and hopefully I won't have the late side effects.

Eating out is a challenge - sometimes I get very bad diarrhea afterwards.  But I can usually find something safe on the menu, so that too is improving.

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