Assessing diarrhoea

If you have diarrhoea for long periods of time it can be very distressing. And you can feel very weak and tired. You become dehydrated because food is passing quickly through the bowel before your body has time to absorb the benefits of the vitamins, minerals and water.

When you have diarrhoea, fluid is also drawn out of the cells in your body into the bowel, and is released in the stool. Losing large amounts of fluid can be dangerous for your body.

Along with fluid, you are also losing important minerals from the cells of your body. These minerals are called electrolytes. They include salt (sodium), potassium, and calcium.

The electrolytes must be in a certain balance for the body to function normally. When they get out of balance it can be harmful to your kidneys and other organs in your body. The salts in the diarrhoea can also make the area around your anus very sore after a while.

Some people may find it hard to talk about having diarrhoea. You may feel embarrassed or upset by your problem. It’s understandable that you may worry that the diarrhoea means your cancer is getting worse or your treatment isn’t working. These feelings are very natural, but it generally isn’t the case.

Try to remember that your doctors and nurses will be very aware of these likely concerns and are used to talking about them. They will be able to reassure you that your diarrhoea is not affecting your cancer treatment. And they will be able to suggest ways to manage your diarrhoea.

Some people say that diarrhoea is the hardest aspect of cancer treatment to cope with. So it is very important that you get some help.

If you find it difficult to talk with your doctors or nurses then it may help to write down any problems you are having and give them to your doctor or nurse to read. It can also help to have a friend or relative come along with you and do the talking.

If you are coming for your treatment and you are in an open day unit, you can ask to go into a private room to discuss your diarrhoea. Your doctors and nurses are aware you will want to talk in private sometimes, so don’t be afraid to ask.

Sometimes diarrhoea can be very difficult to control. This often depends on what is causing your diarrhoea. Your doctor will usually be able to prescribe you some drugs to help. And give you advice about ways to help yourself.

Before your doctor can decide on how best to treat your diarrhoea, they will need to assess how severe the problem is, and find out what is causing it. They will probably want to ask you lots of questions.

It may seem like a lot to deal with if you are feeling very tired. You probably just want your doctor to give you something to help you feel better and leave you alone. But it is extremely important that your doctor does take the time to assess all aspects of your diarrhoea so you get the right treatment.

If you are feeling too tired, and really don’t feel up to answering questions, your family and friends may be able to help.

Your doctor will examine you and possibly arrange some other tests and investigations. Your doctor may ask

• How long have you had diarrhoea?
• When did it start?
• How many times are you opening your bowels each day?
• Are you taking any laxatives or medicines for constipation?
• Do you have to get up at night to open your bowels?
• What do your bowel motions look like?
• What are your normal bowel habits like?
• Do certain foods make your diarrhoea worse?
• Does it happen soon after you have had your cancer treatment?
• When did you last have cancer treatment?
• Are you taking any other drugs?
• Have you made any changes to your diet?
• Are you taking any drugs to help with diarrhoea?
• How much is your diarrhoea stopping you from doing day to day things like shopping, working, getting about the house?

Try to bear in mind that although you may find it embarrassing or inconvenient to speak to your doctor about your diarrhoea, the sooner your doctor can treat it the less likely you are to have more serious problems.