Hi there,
my husband has been on combined immunotherapy for 6 months now. He's on lenvatanib and Pembrolizumab. He's been suffering with diarrhoea recently. Are there any known trigger foods that we should be trying to avoid? Currently bloods are fine so we are not thinking it's autoimmune colitis. And will be discussing loperamide with consultant this week. I was just really wanting to know if there are any dietary modifications that might be able to help?
Kindest regards.
Welcome to our online community here at the Macmillan support line services. My name is Gemma and I’m one of the Cancer Information Nurse Specialists.
Thank you for getting in touch with your question about how to help your husband with his ongoing issue with diarrhoea while on immunotherapy.
Immunotherapy can cause a variety of side effects, including diarrhoea, which can become more problematic the longer they are left untreated.
It is important to report any new, un-improving, or worsening symptom to his hospital team promptly. We are unclear whether your husband has reported this new symptom to his hospital team ahead of the appointment this week. If he has not, we would encourage him to call the treatment advice line number for his own hospital straight away.
But it is especially important if he is having four or more episodes of diarrhoea in any day. Or he has new, or nighttime, incontinence, or has blood in his bowel motions.
After he is assessed, we do have tips on managing bowel side effects, that may be useful. We always recommend that any changes be discussed with the health care team first. Sometimes referral to a dietician for personalised advice is required.
General tips include drinking plenty of non-caffeinated liquid to replace the fluid lost with the diarrhoea, aiming for at least 2 litres per day. He may find it helpful to avoid greasy, fatty foods such as chips and beef burgers, and spicy foods like chilli peppers. Also drinking alcohol and coffee may make his symptoms worse. Eating slowly, and small, frequent meals made from light foods, and eating less fibre until the diarrhoea improve can often help ease symptoms.
The charity Penny Brohn have this really helpful online resource about managing diet while on cancer treatment that covers the symptom of diarrhoea too.
Another place he may like to visit is our online community. People often find the best hints by asking others who may have had a similar experience. While you can’t guarantee the same experience as others, it can help to get some tips. This would in no way replace individual medical assessment.
We also have Macmillan cancer information pharmacists available at most Boots stores, and online if he would like to talk to one about managing this. The pharmacist may be able to recommend over the counter products and supply through the NHS.
If we can ever be of further support, please do get back in touch.
Our Ref: G McR
