Diarrhea

Diarrhea is when you have loose or watery stools three or more times a day. It may cause pain or discomfort in the abdomen (belly) and/or rectum. Diarrhea can cause problems like dehydration, loss of nutrients, weight loss, and fatigue. You should always tell your provider if you are having diarrhea.

What causes diarrhea?

• Diseases of the bowel.
• Some medications and radiation therapy and surgery involving the bowel.
• Bowel infections.
• Anxiety.
• Certain foods and nutritional supplements.

What can I do to prevent or lessen diarrhea?

You can change your diet to help manage diarrhea. You can:

• Eat bland and easy to digest foods like chicken, fish, eggs, puddings, mashed potatoes, noodles, rice, yogurt, cottage cheese, cream of wheat, farina, smooth peanut butter, white bread, bananas, applesauce, canned fruit, and well-cooked vegetables.
• Avoid dried fruits, cruciferous vegetables (broccoli, cauliflower, cabbage, peas), raw vegetables, whole grains, beans, and legumes.
• Soluble fiber is a type of fiber found in some foods that absorbs fluid and can help relieve diarrhea. Foods high in soluble fiber are:
  • Fruits: Applesauce, bananas (ripe), canned fruit, orange, and grapefruit.
  • Vegetables: Boiled potatoes.
  • Breads & pastas: White rice and products made with white flour.
  • Cereals: Oatmeal, cream of rice, cream of wheat and farina.
• Eat small amounts of food 5-6 times a day, instead of three large meals.
• Add nutmeg to foods to slow down the movement of food through the intestines.
• Drink 6-8 glasses of uncaffeinated fluid per day. Water is always a good choice. Some sports drinks (Gatorade®) or broth replace minerals and electrolytes lost through diarrhea.
• Clear liquids may be easier to tolerate. Try clear fruit juices like apple or cranberry, ginger ale, and jell-O.
• Avoid caffeine (cola, coffee, tea), alcohol, milk or milk products, chocolate, dried fruits, beans or popcorn as well as fatty, fried, greasy or spicy foods.
• Avoid very hot and cold beverages.

It may help to keep a food diary to help figure out which foods make diarrhea better or worse for you. 

Care of the rectal area:

• Clean the outside rectal area well after each bowel movement. Use warm water and soap, and pat dry with a soft towel. This will help to prevent burning and irritation.
• Inspect the rectal area each day for red, scaly, or broken skin. Report this to your care team.
• Soak in a warm bath or use a sitz bath, which delivers a continuous, gentle flow of warm water over the rectal area while sitting on the toilet. Sitz baths can be bought at your local drug store.
• Water-repellent creams, such as A & D ointment, help protect the skin. Ask your provider about a numbing ointment if the area becomes very sore.

Can I take over-the-counter medications?

You should not take any over-the-counter medications without talking to your provider first. This includes all over-the-counter anti-diarrheal medications, such as Kaopectate®, Immodium AD®, and Pepto-Bismol®. Diarrhea can be caused by an infection or due to a medication you are receiving and your stool will need to be tested before you take any medication to stop the diarrhea. If your provider decides that it is ok to take these medications they may tell you to take it differently than the package directions.

When should I call my provider?

Diarrhea can result in dehydration and can be uncomfortable. Call your provider right away if you have:

• 6 or more loose bowel movements per day for more than 2 days in a row.
• Blood in or around the anal area, in the stool, on the toilet paper, or in the toilet bowl.
• Less urine output than normal.
• Unable to drink liquids for more than 24 hours.
• Fever over 100.4°F (38°C).
• Weight loss of 5 pounds or more since the diarrhea started.
• Swollen and/or painful abdomen (belly).

Diarrhea can often be treated using medications and by changing your diet. Talk to your provider if you are having any changes to your bowel habits including diarrhea.