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Diarrhea

Diarrhea can be made better or worse by a variety of foods so it is important to pay attention to what you eat. Keep a list of the foods you eat to determine which foods make your diarrhea worse and avoid them.

Foods and drinks that worsen diarrhea are:

  • High-sugar containing foods (cakes, cookies, candy, juice, soda)
  • Dairy (milk, ice cream, cheese)
  • Greasy foods (French fries, fried plantains, bacon, fried chicken)
  • Gas forming foods (beans, broccoli, Brussels sprouts, cauliflower, soda)
  • Foods high in insoluble fiber
  • Caffeine
  • Foods and drinks at extreme temperatures (very hot or cold)

Chronic diarrhea will deplete your body of essential nutrients and electrolytes, so it is important to replenish what is being lost. Sport drinks will replenish electrolytes but have extra sugar, which can increase diarrhea. Bananas, avocados, apricots, coconut, and flavored soup broths are better choices as they can replenish electrolytes without added sugar. Avocados are an especially good source of potassium (975 mg of potassium per avocado). Sprinkle avocado with salt to provide additional sodium.

Helpful Tips

  • Avoid foods that can make your diarrhea worse
  • Be sure to replenish fluids. Drink plenty of water and avoid drinks high in sugar

Food Remedies That May Help:

  • Coconut water and coconut milk are excellent sources of iron, calcium, magnesium, phosphorous, and manganese and have the same electrolytic balance as your blood. For this reason coconut is often referred to as the “blood remedy.” Coconut water is high in both potassium and sodium, whereas coconut milk is a good source of potassium but much lower in sodium. Drink coconut water or milk within one hour after an episode of diarrhea.
  • Include prebiotic-containing foods to your daily meal plan. These foods are nutrition for the good bacteria found in your gut and help keep them nourished. Foods high in prebiotics are asparagus, bananas, beans, kefir, Jerusalem artichokes, chicory root, garlic, flax, leeks, onions, and whole wheat flour.
  • Choose foods high in potassium - figs, yams, avocados, bananas, apricots, peaches, nectar, boiled/mashed potatoes, blackstrap molasses, dates, garlic, winter squash, and yams.
  • Choose foods high in soluble fiber. Soluble fiber intake should not exceed 10 grams per day.
  • In Chinese medicine, leeks and barley (high in soluble fiber) help manage diarrhea. Leeks are particularly good for chronic diarrhea, and barley is best suited for preventative purposes, especially if you are entering a phase of chemotherapy that is associated with severe diarrhea.
  • Umeboshi plums or paste can be used in a variety of dishes. The paste is good as a side to cooked greens such as spinach, kale, or collard greens. Umeboshi vinegar can be substituted for red wine, balsamic, or apple vinegars in many dishes.
  • Prepare a Congee and Date Soup for management of chronic diarrhea: Cook five seedless dates with one cup of congee (1 cup rice to 5 cups water). If you cannot find seedless dates, buy seeded dates and remove the seeds after cooking.

Other Foods That May Help:

  • High sodium foods- any flavored broth, salted pretzels, or saltine crackers
  • White rice with broth, noodles
  • Boiled or scrambled eggs
  • Smooth nut butter (not crunchy)
  • Chicken or turkey baked/broiled, not fried.
  • White bread
  • Vegetables and fruits should be pealed, canned or frozen (skin free)
  • The BRAT diet- Bananas, Rice, Applesauce, and Tea or Toast

If you are having a hard time increasing calorie consumption, here are some ideas:

  1. Smoothies: Combine lactose-free milk, almond milk, soy milk, or coconut water with your choice of fruit. Good options are bananas, oranges, and apples. In addition, you can add oats/oat bran- a good source of soluble fiber.
  2. Soups: Combine a broth (vegetable, chicken, or beef) with vegetables, beans, and rice. If needed, liquefy these foods to the desired consistency and serve as a soup or a drink.
  3. Smaller Meals: Instead of having 3 larger meals, serve 5 to 6 smaller meals throughout the day. For instance, 1 cup of smoothie, a half an avocado with saltines, 1 cup of pureed soup, a piece of skinless chicken with ½ cup of rice, and a piece of toast with jelly.

Herbal Teas

A variety of teas may aid in the management of diarrhea. For the treatment of diarrhea, drink tea throughout the day. For prevention of diarrhea, drink the tea once or twice per day. Raspberry and bilberry have the most appealing taste; however, slippery elm has a long history for helping ailments of the stomach and intestines. Simply select the one that is most appealing to you.

  • Bilberry. Seep 1 to 3 tsp of mashed herb in 8 ounces of warm water for 10 min, strain. Raspberry and bilberry can be combined for an additive effect.
  • Blueberry. Add 3 tbsp of dried blueberries to 8 ounces of water and simmer for 5-10 minutes. Strain and drink at room temperature.
  • Raspberry. Add 1 to 2 tsp to 8 ounces of water, seep for five minutes, strain.
  • Slippery elm. Dilute 1 tsp of slippery elm in warm water, mix until herb is diluted in the water. Drink at room temperature.
  • Marshmallow root. Add 3 tsp in 8 ounces of cold water, seep for 90 minutes, strain.

Supplements

Probiotics may be helpful in managing chemotherapy- and radiation-induced diarrhea. Speak with your doctor to see if probiotics may be indicated for your condition.

  • Probiotics can be beneficial for the prevention and treatment of viral-induced infection and chemotherapy-induced diarrhea, particularly associated with 5-Fluorouracil or Topotecan. Probiotics may also be considered for radiation-induced diarrhea. Combining probiotics with fiber may provide better management of diarrhea.
    • Choosing a probiotic is difficult because there are so many different strains of probiotics and dosing is not simple. Lactobacillus plantarum is preferred for people undergoing cancer treatment. Doses of probiotics are measured by the number of living organisms, known as colony forming units (CFUs). Usually doses of 5 to 10 billion CFUs are recommended. Concentrated versions of probiotics contain up to 450 billion CFUs; however, these doses should be avoided during periods of severe immune suppression due to increased risk of developing an infection.

Adapted from Elena J Ladas, Kara Kelly (2011). Integrative Strategies for Cancer Patients: A Practical Resource for Managing the Side Effects of Cancer Therapy. Singapore: World Scientific Publishing.