Gastrointestinal Symptoms

Nausea and Vomiting

What is Nausea and Vomiting

Nausea is the unpleasant feeling of sickness or discomfort in your stomach that you might vomit, and vomiting is when you throw up what is inside of your stomach. Nausea and vomiting are common and can be caused by a brain or spine tumor, pain, medications used to treat side effects, or treatment.

Ways to Manage Nausea and Vomiting 

• Keep a log of your nausea and vomiting and what you are doing to manage it daily using the My STORI^TM app or a journal.  
• Relaxation techniques can help with nausea and vomiting. You can try breathing exercises, meditation, or tensing and relaxing your muscles.
• Your mood and emotions can affect your symptoms. Try to reduce or manage your stress and anxiety through guided-imagery, acupuncture, or therapy.
• Write down or log your nausea and vomiting symptoms so you can visualize when you feel your best. Try to plan activities during the times you feel your best. 
• Ask your doctor about possible referrals to a registered dietician to help you manage nausea and vomiting.

Some self-care activities you can do to improve your pain can include diet, exercise, sleep, or medication. 

• Try to follow the diet your doctor recommends for you when you are nauseated or vomiting.
• Eating a well-balanced diet is important to give you the key nutrients your body needs to strengthen your immune system and give you energy. When your nausea and vomiting stop, you can go back to your regular diet but start back slowly as your body may not be able to accept it. 
• Stay hydrated by drinking plenty of water and or other liquids and take frequent small sips throughout the day. You can try ginger drinks (ginger ale or ginger tea), broths, clear carbonated beverages, caffeine-free tea, fruit juices (apple, cranberry or grape), sports drink for minerals and electrolytes. 
• Eat low-fiber foods like rice, potatoes without the skin, toast, applesauce and oatmeal. Avoid foods that may upset your stomach, such as greasy or spicy foods. Try to eat six small meals throughout the day.
• Exercise may be difficult if you are experiencing nausea and vomiting. Avoid strenuous activity. Get up and move every couple of hours and ask for help if you feel dizzy or unsteady.  
• Fresh air can help relieve nausea. If you feel up to it, try going for a walk outside. 
• Ask your health care provider what medication or supplements are appropriate for you to reduce your nausea or vomiting. These medications may be prescribed ‘as needed’, so ask when and how to take this medication.
• If nauseated in the morning, try to drink or eat a small amount of bland food such as crackers before trying to take medications. 
• Medications for nausea and vomiting may make you feel sleepy after taking it. 

When to Report Nausea and Vomiting 

Connect with your health care provider and discuss any concerns you have. Share your logged symptoms and self-care activities with them.

• Ask your doctor when and how to report your symptoms to them. 
• Report if your nausea and vomiting get worse, if your symptoms are severe (>7), or your symptoms do not improve from your self-care activities.

Ask your doctor what you should do in the case of an emergency and when your nausea and vomiting should be reported urgently. This may include if you are unable to drink liquids or take your medications in a 24-hour period or if your medication does not relieve your nausea or vomiting. 

Diarrhea

What is Diarrhea 

Diarrhea is when you have frequent or uncontrollable bowel movements that may be soft, loose, or watery. Diarrhea is a common symptom and can be caused by a brain tumor, medications used to treat side effects, or treatment.

Diarrhea may include the following symptoms:

• Abdominal pain and cramping
• Abnormal increase in the quantity or frequency stool
• Loose, watery stools three or more time a day
• Inability to control stools
• Infection: fever combined with dizziness 
• Signs of dehydration: thirst, weakness, heart palpitation, decreased urine output, sunken eyes or dizziness

Ways to Manage Diarrhea 

• Keep a log of your diarrhea and what you are doing to manage it daily using the My STORI^TM app or a journal. 
• Gently wipe and clean your rectal area with mild soap and water or with wet wipes after each stool.
• Apply a soothing topical agent to your rectum or try a warm bath to soothe skin irritation.
• Ask your health care provider about possible referrals to a registered dietician to help you manage diarrhea.

Some self-care activities you can do to improve your pain can include diet, exercise, sleep, or medication. 

• Try to follow the diet your doctor recommends to reduce your diarrhea.
• Foods and beverages that can make diarrhea better:
  • Drink plenty of fluids to replace lost water – aim for at least 64 oz every day.
  • Try to eat 5 to 6 small, frequent, meals each day.
  • Eat food and drink liquids that are high in sodium and potassium (broth, bananas, canned apricots, tomatoes, soup (carrot soup sooths the bowels and increases appetite). 
  • Eat low-fiber foods (rice, potatoes without skin, toast, applesauce, oatmeal) 
  • Avoid foods that can make diarrhea worse:
    • Food or drinks containing alcohol or caffeine 
    • Dairy products (milk, cheese, and ice cream)
    • Fatty, greasy, or spicy foods
    • Drinks and foods containing fructose
    • Fruits (apples, peaches, and pears)
    • Cold food
    • Diet drinks and sugarless gum and candies containing artificial sweeteners
• It may be difficult to exercise when you have diarrhea.  If spending time in the bed or resting, try to get up to walk around or do exercises on the side of the bed to increase blood flow and avoid stiffness
• Scheduling uninterrupted bathroom time before bed or when you wake up may help with diarrhea. This can reduce the number of times you get up at night to go to the bathroom.
• Limit caffeine intake during the day and avoid drinks before bed. 

When to Report Diarrhea

Connect with your doctor and discuss any concerns you have. Share your logged symptoms and self-care activities with them.

• Ask your health care provider when and how to report your symptoms to them. 
• Report if your diarrhea gets worse, if your diarrhea is severe (>7), or your diarrhea does not improve from your self-care activities.

Ask your doctor what you should do in the case of an emergency and when your diarrhea should be reported urgently. This may include if you are experiencing diarrhea that lasts more than 24 hours, dark yellow urine or absence of urine production, nausea and vomiting that accompanies diarrhea, dizziness, rectal bleeding, a temperature higher than 100.4  ̊F, swollen or painful abdomen or red, scaly, or broken rectal skin.

Constipation

What is Constipation

Constipation is when it is difficult or painful to have a bowel movement. You may also feel bloated or uncomfortable. Constipation is a common symptom and can be caused by a brain tumor, medications used to treat side effects, or treatment.

Constipation may include the following symptoms:

• Less frequent bowel movements
• Dry or hard stools 
• Abdominal pain or swelling
• Vomiting
• Anal pain or tenderness
• Inability to pass gas

Ways to Manage Constipation 

• Keep a log of your constipation and what you are doing to manage it daily using the My STORI^TM app or a journal. 
• Try to have a bowel movement at the same time every day. 
• Go the bathroom when you feel the urge to go. 
• Massage your abdomen to help stimulate the bowels. 
• Ask your doctor about possible referrals to a registered dietician to help you manage constipation.

Some self-care activities you can do to improve your pain can include diet, exercise, sleep, or medication. 

• Try to follow the diet your doctor recommends when you are constipated.
• Limit processed foods, which are pre-packaged and contain added sugars and fat.
• Eat high-fiber foods like whole grains, fruits, vegetables, and legumes (lentils, beans and chickpeas). Prunes or prune juice before bed may help promote a bowel movement the next morning.
• Eat six small meals throughout the day.
• Avoid alcohol and sugary drinks. Drink plenty of water to stay hydrated – aim for 8 cups a day. Drink hot liquids 30 minutes before a bowel movement can help relieve constipation. 
• Exercise is any activity that gets your body moving. Being active each day can help prevent or relieve constipation during or after cancer treatment and can improve the way you feel. Regular physical activity, including diaphragmatic abdominal exercise, can help to build abdominal muscles and help with constipation.
• Scheduling uninterrupted bathroom time before bed or when you wake up may help with constipation.

When to Report Constipation 

Connect with your doctor and discuss any concerns you have. Share your logged symptoms and self-care activities with them.

• Ask your doctor when and how to report your symptoms to them. 
• Report if your constipation gets worse, if your constipation is severe (>7), or your constipation does not improve from your self-care activities.

Ask your provider what you should do in the case of an emergency and when your constipation should be reported urgently. This may include if you are experiencing severe abdominal pain, cramping, swelling, or vomiting, temperature higher than 100.4  ̊F or black or bloody stools.

Other GI Symptoms

Other GI symptoms can occur, often in association with the more common symptoms listed above. If you have any of these symptoms, please talk to your doctor.

• Abdominal pain – pain or discomfort in the part of your body between your chest and hips that includes your pancreas, stomach, intestines, liver, gallbladder, and other organs. 
• Incontinence – the inability to control the flow of urine from your bladder or the escape of stool from the bowels. 
• Dry mouth – an unusually dry mouth that can be caused by dehydration or as a side effect from a medication.