INSTRUCTIONS FOR PATIENTS UNDERGOING RADIATION TREATMENTS TO THE PELVIS This information is designed to assist you during your radiation treatments to the lower abdomen and pelvis. Radiation treatments may cause diarrhea, cramping, gas and/or a feeling of fullness. These side effects usually do not develop immediately but usually the second or third week of treatments, and may or may not be a problem, depending on factors such as the dose of radiation being given, the number of treatments, and individual sensitivity. DIARRHEA AND CRAMPING Diarrhea and cramping can occur as a result of radiation therapy. Radiation can cause changes to the lining of the intestine, causing an increased movement of stool through the intestine. This prevents proper absorption of fat, carbohydrates and proteins, which then causes cramping, gas, diarrhea and mucousy stool. These side effects usually do not develop until approximately the second or third week of treatments, and may or may not be a problem, depending on factors such as the dose of radiation being given, the number of treatments, and individual sensitivity. If you currently take a laxative or stool softener, stop the use of this as soon as you notice that the stool is softer or there is an increased frequency of bowel movements. A change in the type of foods that you eat, including lowering the roughage in your diet, will help minimize bowel irritation. Roughage (also called fiber) is the material in foods that is undigested and passed in bowel movements. When your intestines are irritated, normal levels of roughage may be too much. Bulking agents may be used to absorb excess fluid in the intestine. These medications will slow the passage of stool in the intestine, decrease the frequency of bowel movements, and relieve spasms. If you have diarrhea or frequent bowel movements, the anal area may become irritated. Sitz baths will help relieve discomfort. Keep the area clean and pat dry; do not rub. PROBLEM DIARRHEA For the first 24 hours of problem diarrhea, it may be helpful to have frequent small feedings (1-2 ounces) of clear liquids, such as mild carbonated beverages including 7-UP®, ginger ale, non-acid juices including apple and cranberry juice, Hawaiian Punch, Kool-Aid®, Gatorade®, artificially flavored fruit drinks and punches, plain gelatin and Popsicles®. Avoid coffee, milk and milk products, colas, chocolate, orange and grapefruit juice, prune and grape juice. Progress slowly to solid food. Plain starchy foods are usually well tolerated, such as crackers, dry toast, plain boiled white rice, plain boiled white potatoes, cooked cereals such as cream of rice, cream of wheat, and oatmeal. Gradually add protein foods such as cheese, chicken and turkey (baked or roasted). Progress to bland fruits and vegetables including carrots, squash, beets, applesauce and bananas. If tolerating well, follow general guidelines for the Low Roughage Diet. LOW ROUGHAGE DIET - GENERAL RECOMMENDATIONS Eat smaller amounts at frequent intervals, rather than 2 or 3 larger meals. Avoid eating or drinking very hot or ice-cold beverages or foods, since they stimulate bowel activity Drink an adequate amount of liquids, but include them between meals, rather than with meals, to help prevent fullness. Avoid spicy, greasy and fried foods Include potassium-rich foods in your daily diet. Potassium is an important mineral in the body, and is lost when diarrhea occurs. Good potassium sources include: canned apricots and apricot nectar, bananas, oranges and grapefruit and their juices (if tolerated). Other good sources include cooked asparagus, carrots, mushrooms, winter squash, white and sweet potatoes, spinach, pumpkin and Swiss chard. If you have cramps, stay away from foods that encourage gas or cramps, such as carbonated drinks, beer, beans, cabbage, broccoli, cauliflower, onions and highly spiced foods. Use less roughage in your diet by eating only cooked vegetables, and omitting foods with seeds, tough skins, or whole grain. FOOD LIST Recommended Foods That May Cause Distress High-protein Baked or broiled beef, pork, chicken, liver, turkey, veal, eggs, fish, milk, cheese, yogurt. Dried peas and beans such as lentils, kidney beans, white beans, nuts, seeds, peanut butter, and very spicy, fatty meats. Breads, cereals, rice, and pasta Bread and rolls made from refined, white flour; pasta; converted or instant rice. Refined cereals such as farina, cream of wheat, cream of rice, oatmeal, cornflakes. Pancakes, waffles, cornbread, muffins, graham crackers. Whole-grain breads and cereals such as whole-wheat and rye bread, bran, shredded wheat, granola, wild rice. Fruits and vegetables Soups made with allowed cooked vegetables: asparagus tips, beets, carrots, peeled zucchini, mushrooms, celery, tomato paste, tomato puree, tomato sauce, green beans, acorn squash, baked potato without skin. Canned, frozen or fresh fruit. Fresh, unpeeled fruit, pears, melon. All other vegetables. Beverages, desserts, and miscellaneous Butter, margarine, mayonnaise, salad dressing, vegetable oil, cake, cookies, flavored gelatin desserts, sherbet, fruit pie made with allowed fruit, decaffeinated beverages. Desserts with nuts, coconut, dried fruit, chocolate, licorice, pickles, popcorn; foods with a lot of pepper, chili seasoning, taco seasoning, hot sauces. URINARY FREQUENCY AND BURNING Radiation therapy may cause irritation to the lining of the bladder causing pain with urination, urgency, hesitancy, and/or an increase in frequency both during the day and at night. Drink three liters of fluid a day. Avoid caffeine found in coffee, tea and pop and alcohol. Limit the amount of fluid you drink in the evening to prevent having to urinate frequently during the night. Your doctor may prescribe medications to help with these symptoms. Report cloudy, foul smelling urine, backache, fever, chills, or blood in the urine, which could indicate infection. SEXUAL DYSFUNCTION Sexual dysfunction can occur as a result of surgery, medications, and/or radiation therapy, depending on the dose and area of treatment. Radiation can cause changes to the lining of tissues and blood vessels, resulting in dysfunction. Decreased desire for sex may also occur due to the disease itself, pain medications, treatment-related fatigue, stress, or hormonal changes. Medication can be given to control pain, and proper positioning may allow for continued sexual activity. Water soluble lubricants, such as KY jelly®, may be used to avoid friction and discomfort. Your doctor may recommend an urologist or gynecologist for further recommendations. Open communication is encouraged between the patient and partner to discuss fears regarding sexual function. SKIN CARE Your skin may become red and irritated a couple weeks into treatment. This will be a temporary reaction and usually heals within a couple weeks after the completion of your treatment. Remember to treat the area as you would sunburn and avoid any type of irritation, including direct contact with the sun. Do not apply heat, ice or tape to the area. The staff may recommend the use of over-the-counter ointments available at The Regional Cancer Center or at most drug stores. Do not have any ointment on your skin when you come for the treatment. Clean the area with mild soap and water and pat the area dry, being careful not to remove any marks placed on your skin for treatment. Return To Commonly Asked Questions