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Causes of diarrhoea

Diarrhoea can be a side effect of cancer treatment or the cancer itself. Having a combination of treatments can cause more severe diarrhoea.

Let your doctor or nurse know if you get diarrhoea. They can give you advice about what you can do. It is very important you drink plenty of fluids. Otherwise you can easily get dehydrated. 

Cancer treatments

The following cancer treatments can cause diarrhoea:

Chemotherapy

Some chemotherapy drugs irritate the lining of your digestive system. So diarrhoea is a common side effect. It usually comes on in the first few days after each treatment. Some drugs can cause severe diarrhoea.

Radiotherapy

Diarrhoea is quite a common side effect if you have radiotherapy to the pelvic area or back passage (rectum). You may also have stomach cramps or a lot of wind (gas, flatulence).

During radiotherapy the diarrhoea might be quite severe. Let your doctor or nurse know if this happens. It may last for a few weeks after the treatment ends. For many people it then gradually gets better.

Some people have long term changes to their bowel. If you have ongoing diarrhoea, your doctor might need to refer you to a hospital that specialises in bowel problems after pelvic radiotherapy.

Biological therapy

Biological therapies are cancer treatments that use medicines to change cell processes and attack cancers. Some biological therapy drugs can cause diarrhoea.

How bad the diarrhoea is will depend on the particular drug, and the dose that you are having. Let your doctor or nurse know if you have diarrhoea. They will be happy to give you advice or treatment to help manage your diarrhoea.

Surgery

You may have diarrhoea after surgery to your:

  • stomach
  • gallbladder
  • bowel
  • rectum

It might only be a short term problem. But sometimes it can continue for weeks or months after your surgery. Your doctor should discuss this with you before your operation. 

Bone marrow or stem cell transplant

If you have had a bone marrow or stem cell transplant you may develop diarrhoea.

If you have a transplant from a matched donor, you may develop a transplant reaction called graft versus host disease (GVHD). One of the symptoms of GVHD is diarrhoea.

The cancer itself

Some types of cancer are more likely to cause diarrhoea than others - for example, bowel cancer. And some cancers produce hormones and chemicals that cause diarrhoea. Doctors call this paraneoplastic syndrome.

If you have an advanced cancer, the cancer may cause diarrhoea.  Depending on the cause, your doctor or nurse may be able to prescribe treatment to help control it.

Infections

Cancer treatments can weaken your immune system, which means you could get infections more easily. Some types of infection can cause diarrhoea.

Side effects of other drugs

Diarrhoea can be a side effect of many types of medicines. These include:

  • some antibiotics
  • drugs to treat constipation (laxatives)
  • medicines containing magnesium, such as some antacid medicines
  • some anti sickness drugs, such as metoclopramide (Maxalon)

Let your doctor or nurse know if you think you have diarrhoea because of medicines you are taking. They will be happy to help with advice or treatment.

Side effects of herbal supplements

Some herbal medicines can cause diarrhoea. These include:

  • milk thistle
  • ginseng
  • cayenne
  • saw palmetto

We have only mentioned a few herbal supplements that may cause diarrhoea. There are many more, so do ask your doctor’s advice before taking any herbal supplements.

Remember that herbal products aren't necessarily all safe to take. Although they are natural products and you can buy them over the counter at a health shop, some may interfere with your cancer treatment. So it is very important to let your doctor know if you are taking any herbal medicine when you have cancer.

Last reviewed: 
20 May 2014
  • Electronic Medicines Compendium 
    Accessed May 2014

  • Management of chemotherapy induced diarrhoea in adults with cancer
    Produced on behalf of the Greater Manchester and Cheshire Cancer Network by the Network Oncology Pharmacy Group
    2013 version

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