How to Adapt to Bowel Changes After Colorectal Cancer

An estimated 137,000 men and women with a median age of 69 will receive a colorectal cancer diagnosis this year. The American Cancer Society reports deaths from this disease have dropped by 30 percent. While battling colorectal cancer, taking oral chemotherapy medications like Xeloda (capecitabine) can help you survive. Afterward, chronic bowel pattern changes might affect your quality of life. Luckily, lifestyle adjustments can improve loss of bowel control.

Expect Altered Bowel Function

A University of Pennsylvania study of 657 colorectal cancer survivors showed 63 percent had chronic bowel pattern changes, 38 percent suffered from chronic diarrhea, and 23 percent had four to six stools per day. During and after colorectal cancer treatment, your bowel may function differently than you’re used to. Diarrhea and urgency are the two most common problems. At the other extreme, some people experience constipation. Persistent problems may include difficulty containing gas, incomplete bowel evacuation and fecal incontinence. If you don’t have an ostomy, your body will turn food into solid waste. But you may need to defecate more often than usual. After surgery, your bowel may take a few months to adjust. Because your waste-holding area is smaller, you might have more bowel movements and feel an urgent need to evacuate. You may have cluster bowel movements several times an hour. Very low rectal cancer surgery can cause bowel incontinence. If you had combination treatments, your bowel changes could be permanent. Your doctor may direct you to take a fiber supplement like Metamucil four weeks after surgery. By adding bulk to solid waste, this gentle fiber will stretch your rectum over time to reduce frequency and urgency.

Fine-Tune Your Diet

Researchers compared four dietary and behavioral adjustment studies to determine how long-term colorectal cancer survivors regulate bowel function. Study participants included 919 patients living with ostomies or anastomosis at least five years after their colorectal cancer diagnoses. Because of surgeries, 40 to 46 percent changed their diets. Overall, 28 to 43 percent made dietary modifications within a year of treatment. Half of patients with lower quality-of-life scores reported altering their diets, compared to 35 to 41 percent of patients with better scores. Only about 11 percent didn’t need dietary adjustments. Your digestion will take time to settle down after bowel cancer treatment. Maintaining regular meal times will help encourage a regular bowel schedule. Switching your main meal to lunchtime may reduce your overnight bathroom visits. While your bowel heals, eat small, frequent, bland, low-fiber meals. Increase food variety and quantity gradually. The following food lists can help you manage your digestive system’s new state. Avoid problem foods. Menu choices that are most likely to upset the way your bowel works include Brussels sprouts, cabbage, legumes (including beans, lentils and peas), onions, very high-fiber fruits and vegetables, very rich or fatty foods, carbonated drinks, beer and red wine. Relieve diarrhea. Helpful foods include very ripe bananas, boiled rice, gelatin, gummy bears, marshmallows, mashed potatoes, oatmeal, pasta, smooth peanut butter, white bread and yogurt. Ease constipation. Some of these are on the problem list, so test them for tolerance. Try apricots, beans, bran, broccoli, Brussels sprouts, cabbage, caffeinated drinks, chocolate, coffee, garlic, onions, peaches, peppers, plums, prunes, spices, spinach, sweet corn and sugar-free gum. Experiment with limited amounts of different foods to determine which ones maintain a balance between constipation and diarrhea. Keeping a food diary during this trial-and-error period may help you identify foods to avoid. Make a schedule of what you consume and how it affects your bowel. After a while, retest favorite foods that aggravated your condition initially. You may be able enjoy them after your body heals.

Develop Optimal Bathroom Habits

Hold off sitting on the toilet until you feel a strong urge to defecate, usually about 30 minutes after eating breakfast or your main meal. Raise your knees higher than your hips. Lean forward slightly. Rest your elbows on your knees. Don’t strain or you’ll weaken your pelvic floor muscles.

Reclaim Bowel Control Through Exercise

Strengthening your sphincter and pelvic floor muscles can help prevent fecal incontinence. Tighten and hold your buttock muscles like you’re trying to restrain a bowel movement for five to 10 seconds. Release and rest the same amount of time. Notice the difference between tension and relaxation. Repeat this exercise 10 times at four intervals per day while sitting, standing or walking. You may need 12 weeks of exercises to get your muscles back into shape.

Increase Physical Activity

Studies show that patients who follow exercise programs tailored to their personal needs feel better physically and emotionally. Team up with a buddy to keep your routine going. If you weren’t active during treatment, start with short walks. Work your way up to aerobic and resistance training gradually to rebuild your fitness, endurance and muscle strength. Leave home wearing an incontinence pad or adult diaper. Take spares, moist cleansing cloths and a change of clothes in case you have an accident in public. Exercise helps aid digestion, regulate bowel habits, reduce stress and maintain optimum weight. It decreases fatigue, anxiety and depression while boosting your energy level. Keeping your body at its peak condition contributes to you being healthy, fit and cancer free.

Celebrate Your New Normal

If you’re among America’s survivors, you’ve crossed a tremendous hurdle. You’ll feel more like rejoicing if you accept your body’s limitations and learn to manage your post-cancer bowel challenges.