Tips on coping with diarrhoea

There are things you can do to help you cope with diarrhoea caused by cancer or its treatment. This could include:

• managing your diet
• drinking plenty of fluids
• soothing the skin around your back passage (anus)
• being prepared when you go out
• being prepared at home
• resting

Managing your diet

Cancer treatments such as chemotherapy or radiotherapy are more likely to cause diarrhoea rather than anything you have eaten. You don’t necessarily need to alter your diet too much. Instead, it’s best to try to have a healthy balanced diet if you can.

Speak to your healthcare team so they can work out what is causing your diarrhoea. They can also talk to you about what you can do to help treat and relieve your diarrhoea.

Tips for managing your diet

• Eat smaller meals and more snacks.
• Avoid food or drinks containing artificial sweeteners such as sorbitol, mannitol or xylitol. These can make diarrhoea worse.
• If your diet is normally very high in fibre , it might help to reduce foods that are particularly high in fibre. For example, eat less beans, nuts, seeds, dried fruit, bran and raw vegetables.
• To be gentler on your digestive system , try not to eat too much greasy, fatty or spicy food .
• Ask your doctor about anti diarrhoea drugs.

You may find it helps to keep a food diary. It can help you work out which foods make your diarrhoea worse and the foods you can eat without causing problems.

The Royal Surrey NHS Foundation Trust have a video called 'What should I eat if...I have diarrhoea? Tips to help you when you have diarrhoea with cancer'. 

Drinking plenty of fluids

You can lose a lot of fluid if you have diarrhoea, so it’s important to replace the fluid to prevent dehydration .

Tips

• Drink plenty. Aim for 8 to 10 glasses each day if you can. This includes tea, squash and milky drinks as well as soups, custard, jelly and ice lollies.

• Cut down on drinking too much caffeine (particularly in coffee) and avoid alcohol. These can make your symptoms worse.

If your diarrhoea is severe then replacement drinks such as Diarolyte can help. They replace the loss of fluid and salts in your body. Do speak with your nurse, doctor, or pharmacist beforehand for advice. 

The Royal Surrey NHS Foundation Trust have a video called 'What should I do if...I just don't feel like drinking? Tips to support you when you are struggling to drink with cancer'.

Soothing the skin around your back passage (anus)

The skin around your back passage (anus) can become very sore and may even break down if you have severe diarrhoea.

These tips may help:

• use soft toilet paper or damp cotton wool to wipe yourself after you’ve been to the toilet

• have a warm bath to help soothe pain and help with healing – do this a few times a day if necessary

• pat the area dry with a soft towel after a shower or bath – don’t rub

• ask your doctor or nurse about soothing creams, such as E45, vaseline, or zinc cream to apply around your anus

• avoid wearing tight trousers or underwear

• cotton underwear will help to keep the area ventilated – nylon and polyester can make you sweat and cause even more soreness

Radar key and just can't wait card

Many people worry about having access to a toilet when they’re out. There are special keys called radar key’s you can get that gives you access to thousands of toilets in the UK. It also tells you where they are.

Also, you can get a just can't wait card, this gives you peace of mind and access toilets in a rush. 

Speak to your specialist nurse about getting a radar key or just can't wait card.

Being prepared when you go out

One of the hardest things about having diarrhoea is that it can sometimes happen very suddenly. You will probably want to be close to a toilet at all times to avoid accidents.

It is very natural to feel embarrassed and upset if an accident does happen, even if no one else knows about it. You may worry that people will smell it. But your close family and friends will understand and will want to help and make things as easy as possible for you.

To avoid accidents when you go out, you can help to prepare yourself:

• know exactly where the toilets are in the place you are going
• try to avoid long car, train or bus trips. If you need to go on longer journeys, plan when you may need to stop for medication or food
• take spare underwear, pads, soothing creams and a plastic bag with you, just in case
• you can always rinse out underwear in the bathroom sink and put it in the bag to take home – no one needs to know about this
• it may help to take extra toilet roll and wet wipes, in case where you are has run out
• wearing a pad can help to protect your underwear and make you feel a bit safer
• take a spare stoma bag with you if you have a colostomy or ileostomy
• there are products on the market to help mask the smell from a colostomy so ask your stoma nurse about these

Radar key and just can't wait card

Many people worry about having access to a toilet when they’re out. There are special keys called radar key’s you can get that gives you access to thousands of toilets in the UK. It also tells you where they are.

You can also get a just can't wait card, this gives you peace of mind and access to toilets in a rush. 

Speak to your specialist nurse about getting a radar key or just can't wait card.

Being prepared at home

When you are at home, try to:

• protect your mattress – put a large pad, towel, or waterproof mattress protector on your bed if you are worried about having diarrhoea during the night

• leave a night light on near your bed, in the hallway and bathroom to light up where you are going so you can get to the toilet quickly

There are disposable waterproof bed pads made for toddlers during toilet training. These can be very handy and help you to feel more secure. You can buy these, or your nurse may be able to give you some from the hospital, as they use a similar product. You could also contact your local continence advisor by finding them on the Bladder and Bowel Foundation database. 

There are experts in continence that can be found locally to you. They are also sometimes called continence advisors or physiotherapists. A health professional such as a GP or specialist nurse can refer you. In some cases you might be able to refer yourself.

Even if it is embarrassing, it is important to let your doctor know if you are having accidents. They may be able to change your anti diarrhoea medicines.

Resting

Having diarrhoea for more than a couple of days can be exhausting. You are bound to feel very weak and tired if you have lost a lot of fluid. So it's very important to let your body rest when you can.

Ask your family and friends to help you with things like cooking, cleaning the house, shopping and collecting children from school. They really won't mind so don't be afraid to ask. It's important that you get all the help and rest you need.