Diarrhea can be a major problem for cancer patients. Some chemotherapy drugs are notorious for causing diarrhea. These chemotherapy drugs include irinotecan (Camptosar), 5-fu, cetuximab (Erbitux), erlotinib (Tarceva), and capecitabine (Xeloda). Diarrhea can occur with any chemotherapy drug including immunotherapy. Diarrhea associated with immunotherapy is particularly concerning, as it can progress rapidly to severe, even life threatening, diarrhea if not treated aggressively. If you feel weak or dehydrated (dizzy, low blood pressure, marked weight loss) let us know, you will likely need to be seen in the office. We may be able to administer intravenous fluids and keep you out of the emergency room.

If you are having minor problems with diarrhea:

If you are taking any form of immunotherapy, let us now immediately, as this could progress quickly to serious complications

Stop dairy products and change to a bland diet

Try to stay hydrated with 8-10 glasses of fluid daily

Loperamide (Imodium) 4 mg after initial loose stool, then 2 mg every 4 hours or after a loose stool

If you are having moderate problems with diarrhea:

Stop chemotherapy, stop any diuretic medicines (water pills)

Stop dairy products and change to a bland diet

Try to stay hydrated with 8-10 glasses of fluid daily

Loperamide (Imodium) 4 mg after initial loose stool, then 2 mg every 4 hours or after a loose stool

If you are having moderate problems with diarrhea:

Stop chemotherapy, stop any diuretic medicine (water pills)

If you are taking any form of immunotherapy, let us now immediately, as this could progress quickly to serious complications

Stop dairy products and change to a bland diet

Try to stay hydrated with 8-10 glasses of fluid daily

Loperamide (Imodium) 4 mg after initial loose stool, then 2 mg every 4 hours or after a loose stool

Diphenoxylate (Lomotil) 2.5 mg 1 to 2 tablets every 6 hrs as needed

Octreotide 100 to 150 mcg by subcutaneous injection three times a day, up to 500 mcg three times a day

If you are having are having moderate, severe diarrhea or feel dehydrated (weak, dizzy, low blood pressure, marked weight loss)

Go to the Emergency Room if you are becoming dehydrated, you may need hospitalization and continuous intravenous hydration

Additional tests may be indicated to determine a cause for diarrhea other than chemotherapy:

C. diff testing (this is an infection that can occur after using antibiotics)

Stool Cultures

Stool for ova and parasites

Electrolytes

Probiotics involves ingesting foods containing bacteria thought to be beneficial to gastrointestinal health. Bacteria found in sour milk and yogurt called lactobacillus may help establish a favorable bacterial environment in the colon. This may be helpful for cancer patients who have disruption of the bowel flora from chemotherapy drugs or antibiotics. Check the label for yogurts that contain lactobacillus, especially lactobacillus acidophillus.