Managing the symptoms that affect your eating

If you are opening your bowels less frequently than usual and your stools are hard and difficult or painful to pass, you may be constipated. Constipation is a common side effect of cancer treatment, anti-sickness drugs and painkillers. Constipation can be very serious and cause symptoms such as tummy pain, nausea, vomiting and poor appetite.

Dietary changes may not be sufficient to relieve constipation caused by medicines. You are likely to need to take laxatives. Please consult your doctor or specialist nurse for advice.

If you are constipated follow the advice below:

• Aim for at least two litres of fluids per day. This can include water, tea and coffee, squash, fruit juice and milky drinks.

 

• Gentle exercise can help to stimulate the bowels. Keep as active as possible through your treatment.

 

• You may need to increase the fibre in your diet. Good sources of fibre include: fresh fruit and vegetables, dried fruit and wholegrain products. Please be aware that a high fibre diet is not suitable for everyone. Consult your doctor or dietitian if you are unsure about the amount of fibre you should have.
• For more tips, click here to watch our video on constipation.

Chemotherapy and some medications can cause nausea and vomiting. It is not usually related to the food you are eating. Your doctor or specialist nurse can advise you about anti-sickness medications. You may need to try several before you find the one that suits you.

You can also follow these tips to reduce nausea and increase what you are managing to eat:

 

• Try eating dry, bland foods first thing in the morning to settle your stomach. You may find it helps to nibble a biscuit before getting out of bed.

 

• Eating little and often can be helpful. Nausea can be worse if you are either very hungry or too full.

 

• If cooking smells make you feel sick, try eating cold foods. If you prefer a hot meal, ask somebody else to do the cooking. You can also use microwave or oven ready meals so you don’t need to be in the room whilst they are cooking.

 

• Make sure the room you are eating in is well ventilated. Open the windows so that food smells don’t linger.

 

For more tips, click here towatch our video on feeling sick.

Diarrhoea is a common side effect of many cancer treatments. It is unlikely to be due to the type of food you are eating. Please discuss this with your doctor or specialist nurse who will be able to prescribe suitable medications if appropriate.

Diarrhoea may also be a sign of infection. Check your temperature and alert your medical team if you are worried about your symptoms.

It is important to keep well hydrated when you have diarrhoea as you may be losing a lot of fluid.

• Aim for at least two litres of fluids per day. This can include water, tea and coffee, squash, fruit juice and milky drinks.

 

• Diarrhoea is usually caused by treatment, and it is not usually necessary to remove fruit and vegetables from your diet.

 

• Aim to eat small frequent snacks throughout the day to avoid losing weight.

 

• Isotonic sports drinks (e.g. Powerade®, Lucozade sport®, Gatorade®) and rehydration medications (e.g. Dioralyte®) may be required if the diarrhoea is severe and goes on for a long time.
  

 

Dietary changes may be useful in some cases. If your symptoms are ongoing, ask your doctor or your specialist nurse to be referred to a dietitian.

For more tips, click here to watch our video on diarrhoea.

Cancer and cancer treatments can cause your taste to change in the following ways:

 

• Sweet or salty foods become stronger in flavour.

 

• Things you previously liked, you are now unable to eat.

 

• You have found a taste for other foods you previously disliked.

 

• A complete loss of taste.

 

• Food tastes very metallic.

 

It is important to try and eat as normally as possible even if food tastes strange. Missing meals due to altered taste can lead to weight loss.

 

Taste changes can come and go, so it is best to try and have what you fancy at the time. Avoid foods that don’t appeal, but try them again in a few days or weeks as your taste is likely to continue to change and you may enjoy them again.

 

Follow these tips to cope with taste changes:

 

• If you find you prefer stronger flavours, try adding herbs, spices, sauces and pickles to food.

 

• Some people find cold food tastes better than hot. Cold foods smell less strong if food smells are off-putting to you.

 

• Sharp tastes such as fruit, fruit juices and boiled sweets can be refreshing.

 

• You may find tea and coffee no longer taste the same. Try herbal teas, squash or fizzy drinks instead.

 

• If you have a metallic taste in your mouth, you may find it more pleasant to eat using plastic or bamboo cutlery.

 

• If you are struggling to eat meat, try other sources of protein such as fish, eggs, tofu, beans or dairy products.
  

 

Taste changes can also be a result of a dry mouth or oral thrush. If you notice your tongue has a thick white or yellow coating, contact your doctor or specialist nurse. They may be able to prescribe medication to help you.

For more tips. click here to watch our video on taste changes.

A dry mouth is common during some cancer treatments. A dry mouth can allow bugs to build up. It is therefore important to frequently brush your teeth and use mouthwash. If your tongue has a thick white or yellow coating, please discuss this with your doctor or specialist nurse who will be able to prescribe mouth washes or medication to help.

Tips to cope with a dry mouth:

 

• Aim for at least two litres of fluids per day. This can include water, tea and coffee, squash, fruit juice and milky drinks.

 

• Choose soft foods. These will be easier to chew and swallow.

 

• Add sauces and gravy to meals.

 

• Avoid dry foods e.g. crackers, bread.

 

• Use sugar free chewing gum. This can help to stimulate your saliva.

 

• Suck on boiled sweets to stimulate saliva.

 

Use this link to watch a video featuring more tips on eating with a dry mouth.

It is important to speak to your doctor or specialist nurse if your mouth becomes sore. This can be a sign you may be developing mouth ulcers. Treating this early can stop it from getting worse.

 

Tips to cope with a sore mouth:

 

• Choose soft foods as these will be easier to chew and swallow.

 

• Opt for smooth puddings to increase your energy intake e.g. custard, mousse, yoghurt.

 

• Add sauces and gravy to meals.

 

• Avoid hot foods. Opt for warm, cold or frozen foods instead.

 

• Avoid dry foods e.g. crackers, bread.

 

• Avoid spicy foods e.g. chilli, curries.

 

• Avoid acidic foods e.g. fruit, tomatoes.
  

 

Fore more tips, click here to watch our video on a sore mouth.

Feeling very tired is a common side effect of cancer treatment and can make shopping, cooking and eating more challenging. One of the best ways to help with fatigue is to try and do some gentle activity every day. This has been shown to help with energy levels. E.g. go for a short walk round the block, gentle house work or gardening.

 

Tips for coping with tiredness and fatigue:

 

• Frozen, tinned and ready meals can be useful on days when you feel tired. They can be just as nutritious as homemade meals and are much easier.

 

• Plan ahead. On days when you are feeling well, stock up the cupboards and freezer with easy meals and snack options.

 

• Let family and friends help you with shopping and cooking.

 

• If you are really too tired to have a meal, eat a sandwich, snack or nourishing drink instead e.g. hot chocolate, milkshake, smoothie. Don’t be tempted to go to bed without eating as you will feel much weaker and more unwell when you wake up.
  

Cancer treatment can be very stressful and frightening. You may find that this puts you off eating. Changes in your eating patterns may also cause you and those around you to worry. It can be helpful to talk to those close to you, or a counsellor about how you are feeling about your illness and treatment.

The Fountain Centre (found in the Royal Surrey Cancer Centre) offers advice, counselling and a range of complementary therapies, in a calming and relaxed atmosphere.

There are a number of meditation apps on Android and Apple devices which you may also find useful. Mindfulness is currently very popular for stress relief. 

It can be very difficult for family and friends to see somebody they care about struggle to eat. You may find that family members insist on giving you big portions of food because they want to help you. It can be helpful to talk through any problems you are having with eating with those around you. This will help them to understand why you are eating differently. Explain that a smaller portion of food is easier, and that you are likely to eat more if your plate is not too full.

Try not to put too much pressure on meals. Make sure you have a calm, pleasant space to eat in. Some people find being distracted with the television, music, a book or a crossword helps them to eat more without realising.