Dear All
One of the requests for this month's focus on diet was some information about bowels and diet. Almost all of you will have had abdominal surgery and as you'll know, this can have a huge impact on your bowels, some temporary and some ongoing. Bowel issues can be something people are reluctant to discuss, but ongoing diarrhoea, constipation or even discomfort/wind on a regular basis can be hugely debilitating and really impact quality of life.
Please do talk to your CNS or GP if you are experiencing ongoing bowel problems. They can prescribe laxatives (which act in different ways according to the cause of the problem, so if one doesn't work do go back to try something else), stool softeners and anti-diarrhoea medication. They can also refer you to specialist dietitians for expert advice. For more severe symptoms you may need an in-patient admission, either for IV fluids for diarrhoea or enemas/surgery for a blocked bowel, so contact your hospital team quickly for advice if your symptoms are severe (more than 4 episodes of diarrhoea in a day, or diarrhoea for more than 24 hours; constipation along with vomiting and stomach pain).
Everyone's needs will be different depending on the effects of the cancer, surgery and other treatments have on your bowel.Some of you will have been advised to introduce more fibre into your diet to help manage constipation while some of you will be following a low fibre/low residue diet to manage risk of bowel blockage.
Low fibre/low residue are terms that are often used interchangeably but they are different. If you are on a low residue diet this is more restrictive than a low fibre diet, so you need to make sure any information on low residue diets you use is specific to this and not just a low fibre diet - check with your team or specialist dietitian if you're not sure.
Dietary fibre increases the weight and size of your stool and while this can help with constipation, too much fibre will put your bowels under strain and can cause pain and discomfort, abdominal bloating and excessive wind. It is always advisable to check with your team regarding fibre intake for constipation as they will be able to advise you knowing the impact of ovarian cancer and your treatment has had on you as an individual.
Here is some information on bowel problems and foods to consider from reliable sources.
The National Cancer Institute (USA) has useful information on gastrointestinal complications here: cancer.gov/about-cancer/tre...
Advice on diarrhoea from Macmillan: macmillan.org.uk/informatio...
Advice on constipation from Macmillan: macmillan.org.uk/informatio...
Advice on coping with wind from Macmillan: macmillan.org.uk/informatio...
Information on diet and advanced cancer from Cancer Research UK: cancerresearchuk.org/about-...
Ovacome factsheet on blocked bowel/low fibre diet: ovacome.org.uk/wp-content/u...
Guys and St Thomas' information on low fibre diet: guysandstthomas.nhs.uk/reso...
The Healthtalk ovarian cancer section includes a video from a woman who had a blocked bowel treated with enemas then surgery: healthtalk.org/peoples-expe...
The University Health Network of Toronto has a straightforward leaflet on bowel problems after cancer treatment here: uhn.ca/PatientsFamilies/Hea...
Advice on fibre from Cancer Treatment Centres of America (includes a useful list of fibre content in food): cancercenter.com/community/...
NHS Choices has suggestions on how to introduce more fibre into your diet: nhs.uk/live-well/eat-well/h...
Information from the Mayo clinic about adding more fibre to your diet (includes recipes although they are in American cup measurements): epicurious.com/archive/heal...
If you have any questions or concerns about how you should be managing your bowels do contact your medical team to discuss it with them, and don't make any major changes to your diet without checking with your team or specialist dietitian first.
I hope this is helpful. Do let me know if you have any questions.
Best wishes
Anna
Ovacome Support Service Manger