Because chemotherapy destroys cells that are produced at a rapid rate, such as those that line the mouth, stomach, and intestines, it can cause diarrhea, ranging from mild (frequent, soft stools) to severe (abundant quantities of liquid stool). Diarrhea during chemotherapy can also be caused by some antinausea drugs, antibiotics, and intestinal infections. After chemotherapy ends and immune function returns to normal, the lining of the digestive tract heals and the diarrhea ends. Following are parents’ suggestions for coping with diarrhea:

• Do not give any over-the-counter medicine to your child without approval from the oncologist. She might want to test your child’s stool for infection prior to treating the diarrhea. Frequently recommended drugs for diarrhea are Kaopectate®, Lomotil®, and Immodium®.
• It is very important that your child drink plenty of liquids. The liquids will not increase the diarrhea, but they will replace the lost fluids.

My 3 year old had stopped drinking from bottles months before her diagnosis. When she first began her intensive chemotherapy, she had uncontrollable, frequent diarrhea. Liquid would just gush out without warning. One night she said in a small voice, “Mommy, would it be okay if I drank from a bottle again?” I said, “Of course, honey.” It was a great comfort to her, and she took in a lot more fluids that way.

• Hot or cold liquids can increase intestinal contractions, so give your child lots of room-temperature clear liquids (e.g., water, Gatorade®, ginger ale) or mild juices such as peach juice or apricot nectar.
• Diarrhea depletes the body’s supply of potassium, so give your child foods high in potassium, such as bananas, oranges, baked or mashed potatoes without the skin, broccoli, halibut, mushrooms, asparagus, tomato juice, and milk or yogurt (if tolerated).
• Low potassium can cause irregular heartbeats and leg cramps. If these occur, call the doctor.
• Do not serve foods high in fiber, such as bran, fruits (dried or fresh), nuts, beans, or raw vegetables.
• Do not serve greasy, fatty, spicy, or sweet foods. Instead, give your child bland, lowfiber foods such as bananas, white rice, noodles, applesauce, unbuttered white toast, creamed cereals, cottage cheese, fish, and chicken or turkey without the skin.

In the middle of maintenance, my son had severe diarrhea for a week. He had large amounts of liquid stools 20 times a day. I felt so sorry for him. The doctor cultured a stool specimen, but they never identified a cause. It cleared up after a week of the BRAT diet (bananas, rice, applesauce, toast). He had a problem with diarrhea almost weekly throughout his treatment.

• If your child’s anus is sore, check with the doctor before using any non-prescription medicine. He may recommend using Desitin®, A&D ointment®, or Bag Balm® after each bowel movement.

While taking ARA-C my daughter had a terribly sore rectum. It hurt to have bowel movements, she’d cry and have to squeeze our hands to go, then the urine would run back and burn. She was also very itchy. We carried around bags with Q-tips® and every known brand of rectal ointment—A&D®, Preparation H®, Desitin®, and Benadryl®. Thank goodness this cleared up quickly on maintenance.

• Call the doctor if your child has significant pain with bowel movements, especially if your child has low blood counts.