Management of acute cancer treatment-induced diarrhea

Abstract

Objectives: To describe the dietary and pharmacologic management of acute CTID.

Data sources: Primary and secondary literature, and clinical experience.

Conclusion: When dietary strategies do not work, or when patients present with grade 3/4 diarrhea, pharmacologic intervention is required. First-line therapy should be initiated quickly with loperamide or diphenoxylate/atropine in recommended doses. Somatostatin analogues are effective as second-line therapy or as first-line therapy for patients with grade 3/4 diarrhea.

Implications for nursing practice: Oncology nurses should strive to match treatment with the severity of symptoms of CTID. Whatever therapy is chosen, the goal must be to quickly control this debilitating and potentially life-threatening side effect so that primary chemotherapy and/or radiation therapy may be resumed and completed.