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Topic: Need your Tips for Managing Diarrhea

Forum: Managing Side Effects of Breast Cancer and Its Treatment —

This is a place to discuss concerns, tips and strategies for all types of side effects from all types of medications and treatments, (chemo/rads/hormonal/targeted/pain meds/etc.

Posted on: Jul 30, 2019 10:52AM

Moderators wrote:

Tips for Managing Diarrhea— What has worked, what hasn't? Any secret tips?

Thank you! This will help us with our new content we are writing.

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Jul 30, 2019 01:52PM - edited Jul 30, 2019 01:53PM by Moonflwr912

I wish who ever has this side effect big hugs, and the knowledge that this, too, shall pass. Too slowly, but it will. I went to diapers for everyday. Cried when I did, but saved me time, laundry, and embarrasment. Kept a change of clothes in the car. Carried them in a small zippered bag, along with portable wipes, and Aquaphore. Baby wipes are cheaper, more portable and work just fine.

For times I couldnt, just couldnt, have Diarrhea, such as a wedding, or a flight, I used Lomotil. (Diphenoxylate with atropine) It works, but when you stop taking it, its rough. It also has many interactions with other meds.

And, btw, make sure you use Aquaphore after the 2nd episode in a day, and every episode thereafter. It works to keep your skin protected from the feces. The most portable version is the one meant for lips. Just be sure not to get a menthol flavored.... ask me how I know that! LOL

Good luck, and much love.

Sometimes life SUCKS! Sometimes it doesn't. I prefer when it doesn't! If you're ever bored, read my biography. Bring snacks..... LOL Monica Dx 11/11/2011, DCIS, Right, 1cm, Stage 0, Grade 3, 0/2 nodes, ER+/PR+, HER2+ (FISH) Dx 12/8/2011, IDC, 1cm, Stage IA, Grade 3, 0/2 nodes, ER+/PR+, HER2+ Surgery 12/8/2011 Mastectomy: Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 1/17/2012 Reconstruction (left) Targeted Therapy 2/16/2012 Herceptin (trastuzumab) Chemotherapy 2/16/2012 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 8/13/2012 Reconstruction (left): Tissue expander placement Hormonal Therapy 8/20/2012 Arimidex (anastrozole) Surgery 9/10/2012 Reconstruction (left) Surgery 8/14/2013 Reconstruction (left): Tissue expander placement Surgery 9/4/2013 Reconstruction (left) Surgery 12/13/2013 Reconstruction (left): Saline implant; Reconstruction (right): Saline implant
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Jul 31, 2019 12:11PM vlnrph wrote:

Another Wisconite here with my special weapon against this well known side effect of Verzenio. For me, the suggested non-prescription Imodium=generic name loperamide worked too well: everything stopped up and then there were terrible abdominal cramps, etc as it wore off. I did go for a dose reduction also.

By taking two FiberCon or the much less expensive calcium polycarbophil daily, I get absorption of excess fluid which remains in the gastrointestinal tract so bulks up the stool without creating constipation. Curiously, it is stocked with laxative agents. Look near the Metamucil canisters.

Like Monica above, I laid in a supply of disposable underwear. The ones I found on line are designed for fecal, not urinary incontinence, but only come in one size! I put them on after getting thru airport security...

IDC too! 🎻💊👪🐩 🇫🇮 🌹🦋 Rt MX+DIEP 4-2011; ALND 5-2011 d/t micromets; TC X 4; tamoxifen; lymphedema 9-2011; switch to letrozole 3-2014 for 1 yr; bone mets 8-2018: Zometa, rads to spine, Faslodex/Versenio Dx 3/7/2011, ILC, 2cm, Stage IIA, Grade 2, 1/25 nodes, ER+/PR+, HER2-
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Aug 2, 2019 08:29AM mom2bunky wrote:

I realize that side effect diarrhea is completely different from standard, and I apologize if this sounds flippant. But I remember when my son was a baby and would get that explosive diarrhea that children get, the doctors were all about BRAT. Bananas, Rice, Applesauce, and Toast. They're supposedly binding. It helped a lot, and might be worth a try.

Dx at 55. KI-67: 18. Oncotype: 24 Dx 3/26/2019, DCIS/IDC, Right, 2cm, Stage IIA, Grade 1, 0/2 nodes, ER+/PR+, HER2- (FISH) Surgery 5/9/2019 Lumpectomy: Right; Lymph node removal: Sentinel Radiation Therapy 6/26/2019 Whole-breast: Breast Hormonal Therapy 8/5/2019 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Aug 2, 2019 02:26PM pajim wrote:

Aah, Verzenio. When I started it, the pharmacy told me to take two Immodium as soon as the diarrhea started and one every 12 hours thereafter.

That, simply, was a disaster. Maybe it works for some people but not for me. There was war in my intestines. The cramping, the pain, ay yi yi. I tried to be Switzerland but it wan't working.

What helped me was to decide that "normal stools" was not the goal. The goal was to avoid "i have to go to the bathroom right now or else". So I took Immodium in small doses as needed and dealt with generally loose stools. When they got too loose I took another 1/2 Immodium.

Your results will vary. I think how much to medicate this particular side-effect is highly individually variable.

Dx 4/20/2008, IDC, Right, 4cm, Stage IIIA, Grade 2, 1/15 nodes, ER+/PR+, HER2- Dx 2/1/2013, IDC, Stage IV, metastasized to bone, mets, ER+/PR+, HER2- Hormonal Therapy 2/26/2013 Femara (letrozole) Hormonal Therapy 4/21/2013 Faslodex (fulvestrant) Targeted Therapy 2/24/2016 Ibrance (palbociclib) Chemotherapy 6/18/2017 Xeloda (capecitabine) Targeted Therapy 8/14/2018 Verzenio Chemotherapy 1/1/2019 Halaven (eribulin) Chemotherapy 12/29/2019 CMF
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Aug 2, 2019 02:44PM BellasMomToo wrote:

I, too, wore adult diapers on my bad days. Fortunately, I never had an accident, but wore them just in case. Imodium helped, but I had to be careful not to take too much Imodium for fear of getting constipated because I had diverticulosis (pockets in my colon). Then the anti-nausea drugs would make me constipated. So it was quite the balancing act -- some days diarrhea other days constipation.

"Gas X" helped ease the explosiveness of explosive "D", as well as eased gas pains.

Dx'd at age 56. Tumor found by my annual mammogram -- cancer can grow fast! Dx 10/6/2016, IDC, Left, 2cm, Grade 2, 0/1 nodes, ER-/PR-, HER2+ (IHC) Dx 10/6/2016, DCIS, Left, Stage 0, ER+/PR- Targeted Therapy 11/2/2016 Herceptin (trastuzumab) Chemotherapy 11/2/2016 Carboplatin (Paraplatin), Taxotere (docetaxel) Targeted Therapy 11/2/2016 Perjeta (pertuzumab) Surgery 3/27/2017 Lymph node removal: Sentinel; Mastectomy: Left
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Aug 2, 2019 04:57PM SpecialK wrote:

I had 10 days of Big D after each TCH chemo. Not terrible, but bad enough to not leave the house unless I had to. Second 10 days before next infusion were normal. Normal is a comparative thing as I already had IBS-D prior to breast cancer diagnosis thanks to a Nissen surgery many years earlier for severe reflux. Pretty much nothing constipates me - not anesthesia, pain meds, chemo. I have since learned that I have the genetic variant for celiac, so I have altered my diet and there has been improvement. Interestingly, I seem to also be better now that I am off anti-hormonals. I did not really use any meds, just let things run their course but monitored how I was feeling, drank a lot so I did not become dehydrated, ate BRAT foods, avoided anything high fiber, and carbonated beverages or things with caffeine. DO NOT WEAR WHITE JEANS, like moon above, ask me how I!

BMX w/ TE 11/1/10, ALND 12/6/10. 15 additional surgeries. TCHx6 2/17-6/2/11. Herceptin until 1/19/12. Femara 8/1/11, Arimidex 6/20/12, back to Femara 6/18/13-present. Dx 9/27/2010, DCIS, Stage 0, Grade 3 Dx 9/27/2010, IDC, Right, 2cm, Stage IIB, Grade 3, 2/14 nodes, ER+/PR+, HER2+ (IHC)
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Aug 3, 2019 02:47PM mustlovepoodles wrote:

I had bad diarrhea from the very first chemo and nothing would touch it. Eight or nine watery explosive stools a day. I was a community health nurse, so I was in my car driving long distances every day. I knew where every McDonald's and QuickTrip station is in North Georgia. had a few close calls on the road, so I always carried extra clothes, just in case. At home, I actually did have some accidents, sometimes waking in the morning to find poo in the bed. Yuck! Finally, I went to a GI specialist and had a colonoscopy. Everything was clear, so he put me on a very old cholesterol drug called Welchol. The main side effect is severe constipation, which is why they don't use it for cholesterol anymore! However, it was perfect for my situation. I went from having multiple watery stools (and torn up butt!) to having 1-2 merely soft, almost normal stools every day.

Chemo really messed up my colon and left it very irritable. It took about 8 months on the Welchol to get things normalized. I still have a tendency toward diarrhea 4 years later, but not nearly on the same scale at it was.

Oncotype 23. Positive for PALB2 & Chek2 gene mutations. My breasts are trying to kill me! Dx 7/20/2015, DCIS/IDC, Right, 1cm, Stage IA, Grade 3, 0/2 nodes, ER+/PR-, HER2- Surgery 8/20/2015 Lumpectomy Surgery 9/2/2015 Lumpectomy: Right Chemotherapy 10/19/2015 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 2/4/2016 Prophylactic mastectomy: Left, Right Surgery 10/18/2016 Hormonal Therapy Femara (letrozole) Surgery
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Aug 7, 2019 11:45AM cse70 wrote:

Two pieces of advice:

Keep a diary. Even if the first episode of diarrhea surprises you after your first chemo treatment, you will be able to plan for the next ones. I was fortunate enough to take off work on my “Big D” days!

Use disposable diapers. It won’t last forever and soon you will be back to normal!

Hang in there! You can do this!

Dx 10/15/2005, IDC, Right, 2cm, Stage IIA, Grade 3, 0/4 nodes, ER+/PR+, HER2- Surgery 12/14/2005 Lumpectomy; Lymph node removal: Sentinel Chemotherapy 1/31/2006 AC Radiation Therapy 3/31/2006 Whole-breast: Breast Surgery 3/26/2017 Mastectomy: Right Dx 4/1/2017, IDC, Right, 4cm, Stage IIA, Grade 3, ER+/PR-, HER2- Chemotherapy 4/24/2017 Carboplatin (Paraplatin), Taxotere (docetaxel)
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Aug 7, 2019 12:08PM pajim wrote:

Mods, if you're writing about this can you please include a warning. If someone is having a lot of diarrhea and is having trouble eating or particularly drinking, or if they're getting dizzy, call the MO office immediately. Dehydration is nothing to mess around with.

[I know because I lost 25 pounds in 5 days -- it was over a weekend and took us a few days to figure out what was happening. Should have yelled for help two days before I actually did]

Dx 4/20/2008, IDC, Right, 4cm, Stage IIIA, Grade 2, 1/15 nodes, ER+/PR+, HER2- Dx 2/1/2013, IDC, Stage IV, metastasized to bone, mets, ER+/PR+, HER2- Hormonal Therapy 2/26/2013 Femara (letrozole) Hormonal Therapy 4/21/2013 Faslodex (fulvestrant) Targeted Therapy 2/24/2016 Ibrance (palbociclib) Chemotherapy 6/18/2017 Xeloda (capecitabine) Targeted Therapy 8/14/2018 Verzenio Chemotherapy 1/1/2019 Halaven (eribulin) Chemotherapy 12/29/2019 CMF
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Aug 7, 2019 01:56PM Moderators wrote:

Thanks pajim -- our writers will review this whole thread, and will surely take into account your advice -- thanks for that!

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Aug 7, 2019 02:32PM WC3 wrote:

Maybe I just lucked out but I didn't have much. It would just come on suddenly when I did.

But what helped to reduce the amount I had was to keep my portion size small. I snacked more than ate large meals, I fasted the three days I had the dexamethasone, and I couldn't eat much in general. If I had to be pre-emptive, I would take Imodium.

Also, I discovered I could not eat Swanson's chicken broth. Any other brand was fine but Swanson's would give me cramps and diarrhea literally within seconds of eating it. It literally would go right through me. "How is that even possible?" You might ask. Apparently the two ends of the GI tract communicate.

I don't know what my body has against Swanson's but Sprouts is superior in my opinion anyway.

Pathologic complete response (pCR) to chemotherapy. Dx 2018, IDC, Left, 3cm, Grade 3, ER+/PR+, HER2+ (FISH) Chemotherapy 6/1/2018 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 11/15/2018 Lymph node removal: Left, Sentinel; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Targeted Therapy Perjeta (pertuzumab) Targeted Therapy Herceptin (trastuzumab) Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant
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Aug 7, 2019 03:50PM lyzzysmom wrote:

I have been subject to sudden explosive diarrhea since having my gall bladder out a couple of years ago. It has improved slowly but I always avoid coffee and watch what I eat if I am going to be away for home for a while. If I am going to be out and about for a long time i take a swig of Imodium and that really helps.

Oncotype DX 12, age at dx 59 Surgery 5/6/2014 Lumpectomy: Right; Lymph node removal: Right, Sentinel Dx 5/16/2014, LCIS, Stage 0, 0/1 nodes Dx 5/16/2014, ILC, Right, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR-, HER2- Radiation Therapy 6/24/2014 Breast
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Aug 7, 2019 04:10PM kdrake1007 wrote:

After surgery and during chemo, constipation was my problem. But with Verzenio, oh boy! The only other thing I would add to the suggestions already made is to keep a food diary to track your really bad episodes. I’ve found that coffee is a big NO for me. It causes severe cramping and multiple episodes of diarrhea for a day after I drink it. Tea and other drinks with caffeine (don’t drink any soda so I can’t include) don’t cause the same reaction. Salad also often causes problems. I’ve pretty much learned to manage it and do not wear adult diapers, even when flying. I always have Imodium with me and will take before really big events, like my daughter’s wedding. I als take a FiberCon tablet daily.

Dx 3/15/2018, IDC: Tubular, Right, 1cm, Stage IIIA, Grade 3, 4/21 nodes, ER+/PR+, HER2- (IHC) Surgery 4/16/2018 Lumpectomy: Right; Lymph node removal: Sentinel Surgery 4/26/2018 Lymph node removal: Underarm/Axillary Chemotherapy 5/31/2018 AC + T (Taxol) Radiation Therapy 11/14/2018 Whole-breast: Breast, Lymph nodes Hormonal Therapy 1/9/2019 Arimidex (anastrozole) Targeted Therapy 1/31/2019 Verzenio
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Mar 1, 2020 11:10AM roseo wrote:

Would like to second the use of a small amount of fiber to absorb excess fluid.

Dx Stage IV, metastasized to bone, ER+/PR+, HER2-

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