Dealing with Constipation and Diarrhea During Cancer Treatment

A Nutrition Guide for Cancer Patients On Treatment

Constipation can be due to problems that cannot be resolved with food alone. Severe constipation that results from pain or nausea medications, or from digestive conditions, such as a small bowel obstruction, require medical intervention. If you have pain, fever, or abdominal distention (bloating), call your doctor right away. Do not try to self-medicate with food.

If you have less severe constipation, or you have diarrhea, the first thing you should do is talk to your nurse or doctor about this problem. They may be able to adjust some of your medications to help lessen these episodes of bowel irregularity.
Nutritionally, foods rich in fiber can be great for normalizing bowel function. The key is using the right type, and combination, of fiber. Consulting a nutritionist/ dietician can help you make the right choices.

Foods rich in Fiber are classified into two main groups: insoluble fiber and soluble fiber, based on how the small fiber particles act in water. Insoluble fiber particles are typically larger and do not absorb water, so they add bulk to bowel movements and make bowel movements move more quickly. Soluble fiber forms a gel by absorbing water, which helps to both soften hard bowel movements and firm up loose bowel movements seen in diarrhea.

For both diarrhea and constipation, you want to get more foods rich in soluble fiber, such as brown rice, beans, peas and millet. Insoluble fiber foods will only be beneficial for constipation, and can be found in most fruits and vegetables, especially those with seeds and skins.
Many people find that simply taking a daily fiber supplement, which is made up mostly of soluble fiber, will lessen both diarrhea and constipation.Please ask your doctor or nurse if it is okay to add in more fiber before you try a supplement. These products are considered safe for most people; however, some digestive problems may worsen with the addition of a fiber suppliment.

Once you get the okay from your medical team, you can pick up a fiber supplement at any pharmacy or supermarket. Products made with a type of fiber called inulin, or those made of wheat dextrin or psyllium, often work well. Start with one-half serving and plenty of water, to see how your body tolerates the product. Make sure to have at least eight ounces of fluid each time you take a fiber supplement, and drink additional water throughout the day to stay well-hydrated. Adding fiber without adequate water can worsen constipation.Over several days, slowly add in more fiber, as tolerated, to help normalize your bowel function. As well, you can experiment with taking the supplement in the morning, the evening, or both, to determine what works best for you.

If you want to focus on food to get more soluble fiber, try brown rice, millet, beans, peas, carrots, avocado or a banana. For insoluble fiber, try nuts, seeds, and raw vegetables. Its important to note that beans and peas contain significant amounts of both soluble and insoluble fiber.
The bottom line: soluble fiber is good for both diarrhea and constipation. Foods high in insoluble fiber are best for constipation only.

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