1. Diarrhea is:
  • An increase in the number of bowel movements per day or a change in consistency.
  • Diarrhea stools may be loose or watery.
  • Can be an inconvenient side effect of chemo treatment, but can also be life-threatening if not adequately managed.


  1. If diarrhea occurs:
  • Call our office and notify the nurse that you have diarrhea. Also report any fever, nausea, vomiting or abdominal cramps. Maintain a diarrhea log.


  • Collect a stool specimen. Put this in a clean container or come to our office to pick up a container.  Take the specimen to the hospital following the instructions on how the specimen should be stored / handled.


  • After the specimen is collected, start Imodium as instructed. Take 2 tablets immediately, followed by 1 tablet after each loose stool or 1 tablet every 2 hours (if you received irinotecan or 5 FU or Xeloda) until diarrhea is under control for at least 12 hrs.  May take 4 mg by mouth every 4 hrs at night.


  • Increase consumption of clear liquidse. Water, Gatorade and broth.


  1. Diet Modification (Will help reduce discomfort of diarrhea)
  • No alcohol.
  • Avoid greasy, spicy or fried foods.
  • Eliminate high fiber foods (cabbage, broccoli, brussel sprouts and other cruciferous vegetables).
  • Discontinue caffeine containing products (coffee, coke, tea and chocolate).
  • Discontinue lactose containing products (milk and milk products).
  • Your diet should be limited to simple, easy to digest foods, and then expanded as the diarrhea begins to subside.
  • A diet consisting of bananas, rice, applesauce and toast (called the BRAT Diet), and clear liquid is a good starting point.
  • Eventually, you can add pasta without sauce, white meat chicken without skin, scrambled eggs, and other easily digested foods, as tolerated.
  • Stop dietary supplements.
  • Small frequent meals.


  1. Call office again if you have no improvement in 24 hours.


  1. If condition worsens call the office or go to the ER if our office closed.


  1. Antidiarrheal medications (treat diarrhea):
  • Imodium A-D (loperamide)
  • Lomotil (diphenoxylate/atropine)
  • Octreotide 100-150 mcg S/Q bid / tid