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Nutrition and daily life

Diarrhoea: replacing fluids and not missing infection

Diarrhoea can be caused by chemotherapy, antibiotics, infections and reactions after transplant. During neutropenia it can also be a sign of infection. This section explains how to replace fluids, what to eat and when to call at once.

Last updated: ~1 min read
Broth and a rehydration drink.
Figure 1.Replacing fluids — Diarrhoea: replacing fluids and not missing infection

01Short answer

After each episode drink extra: water, broth or oral rehydration solution. Eat small portions of soft, low-fibre foods: white rice, banana, potato, toast, cooked carrot. Avoid greasy, spicy and very sugary foods, caffeine, alcohol and the sugar alcohols in sugar-free gum. Do not take anti-diarrhoea medicine unless your doctor agrees, as it can mask infection. More than 4–6 times a day, blood, fever or belly pain, dizziness or little urine: call at once.

02Simple explanation

Extra fluid each time.

Soft, low-fibre food.

Medicines only with the doctor.

Fever or blood? At once.

03Scientific explanation

Clostridioides difficile: diarrhoea after antibiotics can be an infection with this bacterium; a stool test is needed, and anti-diarrhoea drugs can do harm.

ESPEN: enough energy and protein matter for preventing weight and muscle loss in people with cancer, and nutritional status should be assessed regularly.

NCI: practical eating tips exist for treatment side effects such as nausea, taste changes and mouth sores.

04What happens in the body?

Hygiene

Wash hands with soap after every toilet visit; the family follows the same rule.

White rice, banana and toast.
Figure 2.Soft foods — Diarrhoea: replacing fluids and not missing infection

Skin care

Gentle cleansing and a barrier cream; tell your team about soreness or pain around the anus.

Hands washed with soap.
Figure 3.Handwashing — Diarrhoea: replacing fluids and not missing infection

Dietitian

If you are losing weight, have no appetite or need a special diet, ask to see the hospital dietitian.

Food safety

Food-safety rules for neutropenia (see “Handwashing: the simplest protection” and “Eggs and dairy: safe choices”) apply at every stage.

05Nutrition: four steps

Assess, swap the risky, cook safely, eat regularly.

Assess — Weight and appetite.1AssessWeight and appetite.
Swap — A safe choice.2SwapA safe choice.
Cook — Hot throughout.3CookHot throughout.
Eat regularly — Small portions.4Eat regularlySmall portions.
StrengthEnergy.
ProteinFor muscle.
SafetyFood rules.

06Key points at a glance

TopicIn brief
HygieneWash hands with soap after every toilet visit; the family follows the same rule.
Skin careGentle cleansing and a barrier cream; tell your team about soreness or pain around the anus.
DietitianIf you are losing weight, have no appetite or need a special diet, ask to see the hospital dietitian.
Food safetyFood-safety rules for neutropenia (see “Handwashing: the simplest protection” and “Eggs and dairy: safe choices”) apply at every stage.

07Key terms

Rehydration
Replacing fluid and salts.
C. difficile
A bacterium that can cause diarrhoea after antibiotics.
Dietitian
A nutrition specialist.
Protein
A nutrient for repairing muscles and tissues.
Neutropenia
Low neutrophils.

08Key points

  • Replace lost fluid.
  • Do not self-medicate.
  • Call with warning signs.
  • A diet is not a treatment.
  • Talk to a dietitian.

09Frequently asked questions

Should I take probiotics?

During neutropenia live-microbe supplements may be a risk; talk to your doctor.

Is milk OK?

It worsens diarrhoea for some; yogurt may be better tolerated.

Can a special diet cure leukemia?

No. Good nutrition helps you cope with treatment, but it does not cure.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. Should I take probiotics?

  2. Is milk OK?

  3. Can a special diet cure leukemia?

My questions

12Sources

  1. CDC. C. diff Basics
  2. National Cancer Institute. Eating Hints: Before, During, and After Cancer Treatment
  3. ESPEN. ESPEN practical guideline: Clinical Nutrition in cancer (2021)
  4. Leukemia & Lymphoma Society. Food and Nutrition
  5. World Health Organization. Healthy diet fact sheet
  6. American Cancer Society. Food Safety During Cancer Treatment
  7. National Center for Complementary and Integrative Health (NIH). Green Tea
  8. Memorial Sloan Kettering Cancer Center — About Herbs. Green Tea
  9. MedlinePlus. Caffeine
  10. National Cancer Institute. Diet and Cancer Risk
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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