Gastrointestinal Complications (PDQ®): Supportive care - Patient Information [NCI] - Diarrhea
Tests and procedures may include the following:
- Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient's health habits and past illnesses and treatments will also be taken. The exam will include checking blood pressure, pulse, and breathing; checking for dryness of the skin and tissue lining the inside of the mouth; and checking for abdominal pain and bowel sounds.
- Digital rectal exam (DRE): An exam of the rectum. The doctor or nurse inserts a lubricated, gloved finger into the lower part of the rectum to feel for lumps or anything else that seems unusual. The exam will check for signs of fecal impaction. Stool may be collected for laboratory tests.
- Fecal occult blood test: A test to check stool for blood that can only be seen with a microscope. Small samples of stool are placed on special cards and returned to the doctor or laboratory for testing.
- Stool tests: Laboratory tests to check the water and sodium levels in stool, and to find substances that may be causing diarrhea. Stool is also checked for bacterial, fungal, or viral infections.
- Complete blood count (CBC): A procedure in which a sample of blood is drawn and checked for the following:
- The number of red blood cells, white blood cells, and platelets.
- The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.
- The portion of the blood sample made up of red blood cells.
- Electrolyte panel: A blood test that measures the levels of electrolytes, such as sodium, potassium, and chloride.
- Urinalysis: A test to check the color of urine and its contents, such as sugar, protein, red blood cells, and white blood cells.
- Abdominal x-ray: An x-ray of the organs inside the abdomen. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body. Abdominal x-rays may also be done to look for a bowel obstruction or other problems.
Treatment of diarrhea depends on what is causing it.
Treatment depends on the cause of the diarrhea. The doctor may make changes in medicines, diet, and/or fluids.
- A change in the use of laxatives may be needed.
- Medicine to treat diarrhea may be prescribed to slow down the intestines, decrease fluid secreted by the intestines, and help nutrients be absorbed.
- Diarrhea caused by cancer treatment may be treated by changes in diet. Eat small frequent meals and avoid the following foods:
- Milk and dairy products.
- Spicy foods.
- Foods and drinks that have caffeine.
- Certain fruit juices.
- Foods and drinks that cause gas.
- Foods high in fiber or fat.
- A diet of bananas, rice, apples, and toast (the BRAT diet) may help mild diarrhea.
- Drinking more clear liquids may help decrease diarrhea. It is best to drink up to 3 quarts of clear fluids a day. These include water, sports drinks, broth, weak decaffeinated tea, caffeine-free soft drinks, clear juices, and gelatin. For severe diarrhea, the patient may need intravenous (IV) fluids or other forms of IV nutrition. (See the Diarrhea section in the PDQ summary on Nutrition in Cancer Care for more information.)
- Diarrhea caused by graft-versus-host-disease (GVHD) is often treated with a special diet. Some patients may need long-term treatment and diet management.
- Probiotics may be recommended. Probiotics are live microorganisms used as a dietary supplement to help with digestion and normal bowel function. A bacterium found in yogurt called Lactobacillus acidophilus, is the most common probiotic.
- Patients who have diarrhea with other symptoms may need fluids and medicine given by IV.