Managing Chronic Diarrhea With Colorectal Cancer

Chronic diarrhea is a frequent symptom among colorectal cancer patients, both during and after treatment for the disease. Chronic diarrhea is the frequent passage of loose stools (>3 unformed stools and/or a volume of stool >200 g in 24 hours) with urgency and duration of more than 4 weeks. Chronic diarrhea can result in metabolic disturbances and poor quality of life. There are many causes, both related and unrelated to the physiological changes with colorectal cancer and its treatment. Patients should be assessed for the underlying cause and adverse outcomes of the chronic diarrhea, including dehydration and electrolyte abnormalities. It is managed with fluid resuscitation, electrolyte repletion, diet modification, and a variety of nonpharmacological and pharmacological interventions. Patients should be referred to gastrointestinal specialists and dietitians for collaborative management. A case study is used to illustrate assessment and management of this symptom.