Several years ago, as an entry level dietitian, I received a consult to teach an oncology patient about a “high soluble fiber diet” for diarrhea. I should be embarrassed to admit this, but I actually paged the doctor for clarification.
My initial instinct was that a high fiber diet was contraindicated for someone suffering with diarrhea. I believed that a low fiber diet should have been ordered. Looking back, I find that conversation terribly embarrassing. He had to explain to me that he wanted his patient to increase his soluble fiber and decrease his insoluble fiber.
The doctor knew that soluble fiber would add bulk to the stool. I have to admit, I had a hard time remembering the difference between soluble and insoluble fiber. Part of the confusion was due to the fact that some foods have a combination of both types of fiber.
As an oncology nurse, do you feel comfortable talking to your patients about nutrition tips to manage diarrhea? Do you talk about diet, or limit the conversation to medications? Many gastrointestinal symptoms are well controlled with medication, but the patient’s diet can certainly contribute to distress.
Here’s one example of how a patient’s diet can exacerbate digestive symptoms:
After receiving 20 of 44 radiation treatments to the prostate, Jim started complaining about diarrhea. When asked about his diet, he told the nurse that he had two cups of coffee and a doughnut at breakfast, a healthy salad at lunch, and fried chicken, baked potato, and corn on the cob for dinner. Can you pinpoint where Jim went wrong? The answer is: all of the above! Certain foods and beverages stimulate the bowels. If diarrhea is a problem, hot, caffeinated beverages, raw vegetables, and fatty, sugary foods should be avoided.
Nutrition strategies to manage diarrhea or constipation are important. If altered elimination persists, a patient may limit food intake to minimize discomfort.
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