Gastrointestinal adverse reactions are one of the most common side effects including radiotherapy, chemotherapy, targeting and other treatments. Most of the gastrointestinal adverse reactions are nausea, dyspepsia, constipation, diarrhea, and abdominal pain. Long-term gastrointestinal reactions can also lead to malnutrition and decreased immune function.
Loss of appetite
Anti-tumor therapy may reduce the patient’s appetite or change the taste of food. Adverse reactions such as oropharyngeal discomfort and nausea and vomiting can cause difficulty in eating. In addition, cancer-related fatigue also reduces the patient’s appetite. A normal diet is essential to maintain the normal functioning of patients, especially during cancer treatment. If the patient exhibits dehydration, sudden weight loss, or weakness, the clinician should give relevant treatment recommendations.
Strategies to improve loss of appetite:
(1) Add enough water every day. Dehydration can induce weakness or dizziness, and the dark yellow urine is a clear sign of the body’s lack of water.
(2) Eat less and eat more meals, choose more high-protein, high-calorie foods.
(3) Let yourself move, and moderate exercise will improve your appetite, such as walking for tens of minutes every day.
Anti-tumor therapy (such as chemotherapy) often causes constipation, and taking painkillers, dietary changes, lack of water, and lack of exercise can also cause constipation. Patients with constipation may experience stomach cramps, bloating, and nausea. In contrast, prevention is simpler and more effective than treating constipation-related complications (fecal impaction, intestinal obstruction).
Strategies for preventing or treating constipation:
(1) Choose high-fiber foods, such as adding oatmeal to the food. If you have had bowel obstruction or bowel surgery, you should not eat high-fiber foods.
(2) Drink enough liquid. Normal people drink at least 8 glasses of water every day. Cancer patients should determine the amount of drinking water according to the treatment plan and physical condition. Drinking hot or warm water may be more helpful.
(3) Exercise in moderation every day. Patients with limited mobility can choose to do some simple exercises on the bed or chair. Patients with easy mobility can choose to walk or ride for 15 to 30 minutes every day.
(4) Understand medical knowledge and take medicines strictly according to prescription. Some medicines may cause bleeding, infection or other side effects.
Both anti-tumor therapy and the tumor itself may cause diarrhea or worsen diarrhea. Medications, infections and stress can also cause diarrhea. If the diarrhea is severe or lasts for a long time, the patient’s body cannot absorb enough water and nutrition, which may cause dehydration or malnutrition. Symptoms of dehydration, low sodium, and low potassium caused by diarrhea can be life-threatening. If dizziness or dizziness occurs, the urine is dark yellow or does not urinate, and the body temperature is higher than 38 ° C, the clinician will give treatment advice to the patient.
Strategies for preventing complications related to diarrhea:
(1) Add enough water every day. Cancer patients should determine the daily water intake according to the treatment plan and physical condition. For patients with severe diarrhea, it is suitable to drink clear liquid (without scum) or intravenously add water.
(2) Eat less and eat more. Foods high in potassium and sodium can help alleviate the complications of diarrhea and avoid drinking beverages that may worsen diarrhea.
(3) Confirm the prescription with the doctor before taking the medicine to prevent wrong medication.
(4) Keep the anal area clean and dry. Try to clean with wipes and warm water, or take a bath in warm water.
Mouth and throat discomfort
Anti-tumor treatment may cause discomfort in teeth, mouth and throat. Head and neck radiotherapy may damage the salivary glands, causing difficulty chewing and swallowing. Chemotherapy and biological treatment may also damage the epithelial cells of the mouth, throat, and lips. Mouth and throat problems mainly include: changes in taste, dry mouth, infection, aphthous ulcers, oral mucositis (ulcers), sensitivity to heat and cold, difficulty swallowing, tooth decay, etc. Severe oral problems will lead to dehydration and malnutrition. If the patient has difficulty eating, drinking, or sleeping, or if the body temperature exceeds 38 ° C, ask the clinician to treat it in time.
Strategies for preventing and controlling oral problems:
(1) Dental examination is performed before the treatment starts, and if necessary, teeth are cleaned and repaired.
(2) Check the mouth daily for sores or leukoplakia and clean it in time. Gargle with warm saline every day. Use a soft-bristled toothbrush or cotton swab to gently wipe your teeth, gums, and tongue after meals and before bed. Avoid using dental flossing tools such as floss that can easily cause bleeding.
(3) If you have aphthous ulcers or sore throats, try to choose soft, moist and easy-to-swallow foods, such as soup to soften dry foods. For the treatment of sore throat, you can choose lozenge or spray anesthesia to avoid irritating food such as tobacco and alcohol, too dry or salty and spicy.
(4) Dry mouth increases the risk of tooth decay and oral infections, so sufficient water needs to be added. Sip, chew sugar-free gum, or use alternative saliva products frequently to keep your mouth moist.
(5) Radiotherapy may lead to changes in sweet, sour, bitter, and salty tastes, and chemotherapy drugs may bring oral foreign body sensation from chemical agents or metal preparations. For different taste changes, choose the food that suits you. Cold dishes may be helpful in improving taste.
Nausea and vomiting
Anti-tumor therapy-related nausea and vomiting can be divided into expected type, acute type, and delayed type. Controlling nausea and vomiting can help prevent more serious health problems, such as malnutrition and dehydration. Anti-nausea drugs or antiemetic drugs can effectively prevent or relieve nausea and vomiting.
Strategies to control nausea and vomiting:
(1) Take anti-nausea drugs. Some patients need to take anti-nausea drugs even if there is no malignant vomiting reaction. If the effect of the drug is not good, you can try to consult a medical staff to change the drug.
(2) Add enough water, such as fruit juice, ginger ale, tea or sports drinks.
(3) Don’t eat greasy, deep-fried, sweet or spicy foods, try to eat foods or cold dishes without pungent taste.
(4) Pay attention to dietary arrangements on the day of treatment and try to avoid eating or drinking within 1 hour before and after treatment.
(5) Try other alternative therapies, such as acupuncture, deep breathing, hypnosis or other relaxation techniques (listening to music, meditation), etc.
Recommendations for maintaining a comfortable diet during treatment.
Some types of chemotherapy can cause oral ulcers, also known as oral mucositis. To heal as soon as possible, avoid spicy food, alcohol and warm food. Keep your mouth moist by drinking plenty of liquids throughout the day. It may also help to rinse your mouth with salt water after a meal.
Diarrhea and vomiting at low fluid intake can cause dehydration. Signs of dehydration may include dry lips, sunken eyes, low urine output (dark yellow when urine is concentrated), and inability to produce tears. Drinking plenty of water can help you avoid dehydration.
Eating normal temperature food instead of overheated food, chewing ginger candy, or drinking mint or ginger tea can help prevent nausea. It is best to avoid greasy or fried foods and foods with a strong smell.
During chemotherapy, eating less food is often better than a lot of food. Fewer and more frequent diets can also help nausea.
It is helpful to m
eet with a registered dietitian food and nutrition expert. A dietitian can help you solve specific food and diet problems encountered during cancer treatment.
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