Extreme Diarrhea After Surgery/Chemo

I was diagnosed in January '07 with stage 3 rectal cancer.  After a PET scan it also showed an area of my small intestine affected.  I had a port installed and started 30 treatments of radiation and 24 hr a day chemo.  Surgery was in May and then chemo treatments thereafter.  My biggest problem is trying to control my bowel movements.  Even tho it has only been 4 weeks since chemo I still have diarrhea.  It comes on immediately and if I am not within a few steps of my commode -- well, look out!!!  I have tried imodium, lomotil, and opium tincture.  Can't say any of them have worked consistently. 

 I am wondering if anyone else has experienced my side effects and if so how long did it take to get back to "normal" if that is possible with a large section of rectum removed as well as a small portion of intestine.

 Thanks for any help you can give. 

I had the same problem, but with a stage 2 after surgery.  I tried opium tincture during radiation induced diarrhea and it worked good.  But during the chemo and after the chemo it didn't work.  The only sure thing was Hydromet.  Hydrocodone (Vicodine) is related to Hydromet but has tylonol in it and therefore is bad for the liver if used for a long time.   Besides Hydrocodone is not given out any more in some places.

Hydromet gets me through the day so I can go to work.  Natural anti-diarrhea things are toast, applesauce, rice.  

Hope this helps.

Ron 

On 11/17/2007 Dabblerz wrote:

I had the same problem, but with a stage 2 after surgery.  I tried opium tincture during radiation induced diarrhea and it worked good.  But during the chemo and after the chemo it didn't work.  The only sure thing was Hydromet.  Hydrocodone (Vicodine) is related to Hydromet but has tylonol in it and therefore is bad for the liver if used for a long time.   Besides Hydrocodone is not given out any more in some places.

Hydromet gets me through the day so I can go to work.  Natural anti-diarrhea things are toast, applesauce, rice.  

Hope this helps.

Ron

I was diagnosed with stage 3 rectal cancer in August & began a pre-operative course fo treatment for 5 1/2 weeks of daily radiation and 2X daily doses of Xeloda.  At the end of week 4, I had grade 3 diarrhea (12-15 times per day) & developed excruciating external hemmorrhoids & anal fissures.  During one week of hospitalization, chemo was halted & I started with 3X daily injections of octreotide & small dose of endocet every 4 hours for pain.  Sent home after lessons on self-injection plus nitro-glycerin ointment for direct topical applications.  Two weeks later I was diarrhea-free & I've also completed full regimen of neoadjuvant radiation.  Anal area is healing slowly, but surely.

The octreotide is what helped me turn the corner in controlling my rampant diarrhea.

Surgery (that will hopefully save my sphincter & give me a temporary ileostomy) awaits me in January, followed by 4-5 months of post-operative XELXOX.

I hope you will soon be well.

On 12/1/2007 KarenLee wrote:

I was diagnosed with stage 3 rectal cancer in August & began a pre-operative course fo treatment for 5 1/2 weeks of daily radiation and 2X daily doses of Xeloda.  At the end of week 4, I had grade 3 diarrhea (12-15 times per day) & developed excruciating external hemmorrhoids & anal fissures.  During one week of hospitalization, chemo was halted & I started with 3X daily injections of octreotide & small dose of endocet every 4 hours for pain.  Sent home after lessons on self-injection plus nitro-glycerin ointment for direct topical applications.  Two weeks later I was diarrhea-free & I've also completed full regimen of neoadjuvant radiation.  Anal area is healing slowly, but surely.

The octreotide is what helped me turn the corner in controlling my rampant diarrhea.

Surgery (that will hopefully save my sphincter & give me a temporary ileostomy) awaits me in January, followed by 4-5 months of post-operative XELXOX.

I hope you will soon be well.

I am interested in the nitro-glycerine ointment you used.  Was there a name to the med?  Can't seem to find it anywhere on the internet.  Did this help the burning and general discomfort associated with constant diarrhea? 

 Thanks for any info you can provide. I am going to ck with my doctor on the octreotide.  Sounds like it worked for you and this gives me encouragement!

Sorry that I didn't have the opportunity to check my messages for a week.

The nitroglycerin ointment was mixed for me in the hospital pharmacy.  If your doctor writes a prescription for you, you should be able to get it filled at almost any pharmacy.

The strength I had was .2%.  You can also request it at .3%, but the stronger it is, the more it can cause headaches as a side effect.  (I had no problem except slight occasional lightheadedness right after I applied the ointment.)

I used it 3X per day, preferably right after a bowel movement & always before bedtime.  You don't need much & I cut the fingers off latex gloves to apply it & keep it off the skin on my hands.

In a one clinical trial, they determined it was effective for anal pain in only 50% of the patients in the study, but it sure worked to relax & heal that tender area for me !!

Best wishes & heal well.

On 12/20/2007 KarenLee wrote:

Sorry that I didn't have the opportunity to check my messages for a week.

The nitroglycerin ointment was mixed for me in the hospital pharmacy.  If your doctor writes a prescription for you, you should be able to get it filled at almost any pharmacy.

The strength I had was .2%.  You can also request it at .3%, but the stronger it is, the more it can cause headaches as a side effect.  (I had no problem except slight occasional lightheadedness right after I applied the ointment.)

I used it 3X per day, preferably right after a bowel movement & always before bedtime.  You don't need much & I cut the fingers off latex gloves to apply it & keep it off the skin on my hands.

In a one clinical trial, they determined it was effective for anal pain in only 50% of the patients in the study, but it sure worked to relax & heal that tender area for me !!

Best wishes & heal well.

KarenLee:  Thanks so much for the information. I now have something to ask my oncologist and do so in an intelligent manner (thanks to your message). I look forward to controlling the burning and pain associated with diarrhea. Would love to get rid of it altogether, but time will tell.

 Jeanette

Karen Lee:  I was wondering how your surgery in January turned out.  Keep me posted as you are in my thoughts and prayers.

J'nette

Hi, J'nette --

Surgery was a bit rough.  I felt as though I was gutted like a deer.  The ileostomy took a little while getting used to, but I'll (hopefully) get it reversed in about 8 or 9 months.

The good news was that the neoadjuvant radiation & chemo was worth it.  The tumor itself was totally destroyed!!  My surgeon couldn't even find it during pre-op exam.  The (slighty) bad news was that one lymph node was positive, but only 1 out of 18.  But for now, I'm CANCER-FREE.

So I started preventive Xelox regimen March 10 with my first oxaliplatin infusion.  I'm on a 21-day cycle with 1 infusion followed by 14 days of 1650 mg X2 of Xeloda.  Am looking forward to next week of rest from chemo.  Then we begin again....for 8 cycles if my body can stand it.

My terrific oncologist & I together defined my adjuvant treatment regimen.  The hematology/oncology committee approved my request to self-administer 1.5 mg B12, 100mg B6, 30 mg Glutamine, & 400 IU E daily to prevent or mitgate neuropathy & hand-foot syndrome side effects.  I presented the HEMOC committee with documentation of the clinical trial evidence that these supplements were both effective in counter-acting side effects and did not decrease the efficacy of the chemo drugs.

So far..so good.  But I know the start of chemo is the easy part...the challenge is yet to come.

Please tell me how you are doing.  How is your recovery progressing?  I have added you to my prayers that all of your treatment will have protected you.