Managing Cancer-related Diarrhea: A Whole Person Approach

Diarrhea at a glance

Diarrhea can happen during and even after some cancer treatments, and some medications can contribute to diarrhea. Awareness of complementary therapies and lifestyle practices to ease the symptoms of diarrhea can help improve your quality of life.

On this page

Diarrhea: an overview ›

Top evidence-based practices and therapies for managing diarrhea ›

Helpful links ›

Diarrhea: an overview

What is diarrhea?

Diarrhea occurs when your stools are loose and watery, and you may need to have a bowel movement more often than usual. 

What can cause or trigger diarrhea?

Diarrhea can be caused by many different factors, including medications commonly used during cancer treatment.1Diarrhea. Johns Hopkins Medicine. Viewed September 23, 2024; Diarrhea. Mayo Clinic. Viewed August 1, 2024. 

  • Cancer treatments, including some chemotherapy, immunotherapy and targeted drugs and  radiation to the abdomen or pelvis 
  • A reaction to other medications 
  • Complications of cancer treatment such as graft-versus-host-disease from bone marrow or stem cell transplant, or damage from radiation treatment
  • A bacterial, parasitic, or viral infection
  • Trouble digesting foods, food allergies, or sensitivities
  • Inflammatory bowel disease
  • Irritable bowel syndrome
  • Recent surgery on the stomach, gallbladder, or intestines
  • Recent antibiotic use
  • Supplements including aloe, milk thistle, or high doses of oral vitamin C2American Cancer Society. What Is Diarrhea? April 22, 2024. Viewed October 31, 2024.
  • Excess hormones from a tumor 

What are signs and symptoms of diarrhea?

Diarrhea can be accompanied by any of these symptoms:

  • Belly cramps and bloating
  • Abdominal pain 
  • Upset stomach or nausea
  • Frequent bowel movements 
  • Difficulty controlling your bowels
  • Dehydration
  • Headaches
  • Fever 

Because diarrhea can lead to dehydration, drinking extra fluids may be needed. Severe diarrhea for several days can indicate a serious condition requiring medical care. Consult your doctor if you experience abdominal pain or if you experience diarrhea for more than two days. Bloody diarrhea is always a concern. Call 911 or go to the emergency room if you:3American Cancer Society. What Is Diarrhea? April 22, 2024. Viewed October 31, 2024.

  • Have bleeding from your rectum that won’t stop
  • Have sudden, intense belly pain that won’t stop
  • Can’t urinate (pee) or eat for a whole day or more

Top evidence-based practices and therapies for managing diarrhea 

We present approaches to managing diarrhea backed by modestsignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently), goodsignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently), or strongconsistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analyses of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results (this is the CancerChoices definition; other researchers and studies may define this differently) evidence of effectiveness.

Conventional therapies

If diarrhea is due to an infection, antibiotics may be prescribed by your doctor. Other medications are available to help with diarrhea; your doctor can recommend the best options for you. 

Lifestyle practices

  • Eating Well can reduce the severity and duration of diarrhea. Women eating a low‐fat, low‐lactose diet have experienced less diarrhea during pelvic radiotherapy. Immunonutrition also leads to less diarrhea during cancer treatments.4Pole L, Hepp N. How can Eating Well help you? What the research says. CancerChoices. April 14, 2024. Note that fiber, especially soluble fiber, may be recommended for diarrhea, especially chronic diarrhea. Fluid and mineral replacement is very important to prevent dehydration and becoming seriously ill from mineral imbalance. See BRAT Diet › from the Oregon Clinic

Complementary therapies 

  • Acupuncture is a practice of inserting fine needles into the body at specific points. People treated with acupuncture experience less chemotherapy-related diarrhea.5Hepp N. How can acupuncture help you? What the research says. CancerChoices. August 28, 2024. See Acupuncture: affordability and access ›
  • Moxibustion involves burning an herb to apply heat close to the skin at specific points. People with cancer treated with moxibustion experience less nausea and vomiting during or after conventional cancer treatments.6Hepp N, Pole L. How can moxibustion help you? What the research says. CancerChoices. May 28, 2024. See Moxibustion: affordability and access ›
  • Probiotics are living microorganisms that are available in many foods, such as yogurt, or as supplements. People with cancer treated with probiotics have a lower risk and severity of treatment-induced diarrhea.7Hepp N, Jackson A. How can probiotics and prebiotics help you? What the research says. CancerChoices. August 28, 2024. See Probiotics and Prebiotics: affordability and access ›

Helpful links

Oregon Clinic logo

BRAT Diet ›
This includes an expanded list of foods for the customary BRAT (bananas, rice, apples, and toast) diet for people recovering from diarrhea

Authors

Nancy Hepp, MS

Lead Researcher
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Ms. Hepp is a researcher and communicator who has been writing and editing educational content on varied health topics for more than 20 years. She serves as lead researcher and writer for CancerChoices and also served as the first program manager. Her graduate work in research and cognitive psychology, her master’s degree in instructional design, and her certificate in web design have all guided her in writing and presenting information for a wide variety of audiences and uses. Nancy’s service as faculty development coordinator in the Department of Family Medicine at Wright State University also provided experience in medical research, plus insights into medical education and medical care from the professional’s perspective.

Nancy Hepp, MS Lead Researcher

Christine Mineart, MPH

CancerChoices Program Director
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Christine has a dynamic background in the life sciences, public health, and program operations. Her career began at the lab bench with a Gates Foundation-funded HIV Vaccine research group, which led her to graduate studies in public health epidemiology at UC Berkeley. Her research experience spans clinical epidemiology research to evaluating the impacts of community nutrition programs in Los Angeles, the Central Valley, and Oakland. Most recently she has worked in executive operations for a seed-stage venture capital firm based in San Francisco. Personally, Christine is passionate about holistic health and wellness. She is a clinical herbalist and Reiki master, and she has been practicing yoga for 15+ years. She brings a breadth of experiences to her work leading the CancerChoices program.

Christine Mineart, MPH CancerChoices Program Director

Reviewer

Laura Pole, MSN, RN, OCNS

Senior Clinical Consultant
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Laura Pole is senior clinical consultant for CancerChoices. Laura is an oncology clinical nurse specialist who has been providing integrative oncology clinical care, navigation, consultation, and education services for over 40 years. She is the co-creator and co-coordinator of the Integrative Oncology Navigation Training at Smith Center for Healing and the Arts in Washington, DC. Laura also manages the “Media Watch Cancer News That You Can Use” listserv for Smith Center/Commonweal. In her role as a palliative care educator and consultant, Laura has served as statewide Respecting Choices Faculty for the Virginia POST (Physician Orders for Scope of Treatment) Collaborative as well as provided statewide professional education on palliative and end-of-life care for the Virginia Association for Hospices and Palliative Care.

For CancerChoices, Laura curates content and research, networks with clinical and organizational partners, brings awareness and education of integrative oncology at professional and patient conferences and programs, and translates research into information relevant to the patient experience as well as clinical practice.

Laura sees her work with CancerChoices as a perfect alignment of all her passions, knowledge and skills in integrative oncology care. She is honored to serve you.

Laura Pole, MSN, RN, OCNS Senior Clinical Consultant

Last update: November 4, 2024

Last full literature review: November 2024

CancerChoices provides information about integrativein cancer care, a patient-centered approach combining the best of conventional care, self care and evidence-informed complementary care in an integrated plan cancer care. We review complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocial therapy, and acupuncture therapies and self-care lifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices to help patients and professionals explore and integrate the best combination of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy and complementary therapies and practices for each person.

Our staff have no financial conflicts of interest to declare. We receive no funds from any manufacturers or retailers gaining financial profit by promoting or discouraging therapies mentioned on this site.

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