Effects of Chemotherapy on the Digestive Tract

Chemo can do a number on your guts.

Some of the side effects of chemotherapy can include nausea, vomiting, diarrhea, and constipation. The good news is that all of these side effects are temporary, and very treatable.

Nausea and vomiting are side effects that are a common concern for chemotherapy patients. There are new drugs with can eliminate or diminish this side effect. Contact your doctor if the nausea and vomiting are not being helped by the medication, or if you can't keep liquids down. Here are some tips that may help control these symptoms.

• Before treatment, try eating a light meal.
• Concentrate on breathing slowly and deeply when feeling nauseated.
• Drink plenty of liquids, or suck on ice chips, but do so an hour before or after mealtimes.
• Eat several small meals throughout the day instead of three large ones.
• Eat and drink slowly, chewing well.
• Eat foods cold or at room temperature to avoid being bothered by strong odors.
• Eating foods like cereal, toast, and crackers before getting up can help with morning nausea. This is not recommended for anyone with mouth and throat sores, or who has trouble producing saliva.
• Rest as you need to, but don't lie flat for at least 2 hours after a meal.
• If you get nauseous during treatment, fast for a few hours before.
• Keep busy to distract yourself from the nausea by watching TV, talking with friends and family, or working on hobbies.
• Suck mints or tart candies (again not recommended for anyone with mouth or throat sores).
• Take anti-nausea medication 30 minutes before eating.
• Try to avoid foods that are fatty, fried, or sweet.
• Try drinking clear unsweetened fruit juices (such as apple or grape), and light colored sodas that have lost their fizz (gone flat).

Chemotherapy can affect the cells that line the intestine, and diarrhea may be the result. If diarrhea is troublesome, doesn't clear up in 24 hours, or is accompanied by pain or cramps, talk to your doctor. Don't take over the counter diarrhea medicine without talking to your doctor first. If the diarrhea is severe, your doctor may prescribe medication, or recommend intravenous fluids to avoid dehydration. Here are some tips to keep diarrhea at a minimum.

• Drink plenty of fluids at room temperature such as water, broth, sports drinks, or ginger ale to keep from getting dehydrated. Remember to sip them slowly.
• Eat foods that are low in fiber such as white bread, white rice or noodles, creamed cereals, ripe bananas, canned or cooked fruit without skins, cottage cheese, yogurt without seeds, eggs, mashed or baked potatoes without the skin, pureed vegetables, chicken, or turkey without the skin, and fish.
• Eat several small meals throughout the day instead of three large ones.
• If you're lactose intolerant, avoid milk products.
• Keep your potassium level up by eating bananas, oranges, potatoes (boiled or mashed), and peach and apricot nectars (as long as they are on the diet given to you by your doctor).
• Stay away from coffee, caffeinated tea, alcohol, sweets, and fried, greasy, or spicy foods which can make diarrhea worse.
• Stay away from high fiber foods such as whole grain breads and cereals, raw vegetables, beans, nuts, seeds, popcorn, and fresh and dried fruit.

Some medicines, such as pain medication, can cause constipation. Low amounts physical activity, fluids, and fiber can also contribute to constipation. If you go a day or two without moving your bowels, call your doctor and follow their instructions. Here are some other tips about avoiding constipation.

• Ask your doctor about increasing the fiber in your diet. Examples of high fiber foods are bran, whole-wheat breads and cereals, raw or cooked vegetables, fresh and dried fruit, nuts, and popcorn.
• Avoid cheese, chocolate, and eggs which can cause constipation.
• Check with your doctor about starting an exercise program, or try taking a walk every day.
• Drink lots of fluids including water and warm or hot liquids.

If you have more questions about your chemotherapy, or with any other issues related to cancer, the National Cancer Institute has several resources, including staff to answer telephone calls, faxes, and email. Please see this list for more information.