Ask Registered Dietician Esther Trepal

Ask Esther: Intestinal Problems From Chemotherapy

by Esther Trepal MS RDN on September 6, 2016

Question: I’ve been dealing with diarrhea after chemo treatments. Are there any foods I should eat or avoid to help with this problem?

Answer: Not all chemotherapies have diarrhea as a possible side effect. One thing I would suggest is to discuss this potential with someone on your healthcare team before your treatment begins. Also, and this is very important, ask for some guidelines on when you need to take action — that is, when should you use an anti-diarrheal or when you need to call your doctor. Get a recommendation for a medication and have it on hand just in case.

At the same time, there are some simple things you can do in terms of diet to help control or lessen diarrhea.

Foods that stimulate the digestive system should be avoided. It’s a long list, but here goes: high fiber foods, spicy foods, fried/greasy food, dairy products (except lactose-free), caffeine, alcohol, sweet drinks, products sweetened with sorbitol or xylitol, apple juice (contains natural sorbitol) and foods that are at very high or low temperatures. 

On the other hand, some foods help to form stools and settle the digestive tract. There’s a common acronym used: B-R-A-T. B is for bananas, R is rice, A is applesauce and T is toast. I suggest incorporating these foods into a simply prepared, bland diet. Cooked or processed fruits and vegetables will likely be better tolerated. It may also be helpful to eat small, frequent meals, rather than eating a lot at any one time.

Replacing fluids, potassium and sodium deserves a special mention. These are lost in our stools. Some good beverages are water, ginger ale, sports drinks, and unsweetened coconut water. Clear juices may be tolerated, including diluted cranberry or grape juice. Broth is a good source of both sodium and fluids. For potassium, eat bananas, canned apricots, or potatoes.

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