Xeloda-induced diarrhea

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Faithandpeace
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Joined: Thu Aug 17, 2017 12:25 pm
Location: California

Xeloda-induced diarrhea

Postby Faithandpeace » Wed Nov 08, 2017 12:37 am

My husband started Xeloda two weeks ago. Two weeks on then one week off. Toward the end of the first two weeks, he started getting diarrhea 3-4 times a day. It really exhausted him. The pharmacist told him to take Imodium.

Has anyone successfully treated Xeloda-induced diarrhea with anything natural such as supplements, enzymes, etc? He'd rather not take Imodium.

Thank you.
DH dx 12/16, age 56, stage IV, mets to liver and lungs
5 tx Folfox + Avastin + clinical trial, 1/17-3/17, good results
Immunotherapy in Germany + 3 TACE, 2 TPCE (3/17-6/17)
Folfox + Avastin 8/17, 4 tx
10/17 xeloda + Avastin
12/17 PET negative in liver and lungs. Primary tumor thriving
1/6/18 LAR, temp loop ileostomy, horrible complications, 10 weeks in hospital, still recovering, 4/18.
4/30/18: Y90 to left lobe of liver
6/18: ablations to liver + lung mets

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ocstacy
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Joined: Mon Jun 19, 2017 11:29 pm
Facebook Username: stacy

Re: Xeloda-induced diarrhea

Postby ocstacy » Wed Nov 08, 2017 1:41 am

Immodium is the only med that worked for my mama. I would listen to what the dr and nurses tell you to take. You don't want to get dehydrated. Best of luck
Caregiver/daughter to dear mother age 78, dx 5/09/17 because of me!! :wink:
Rectal CA Stage 3 low-grade adenocarcinoma- 6 cm
Neoadjuvant start 7/10/17 ended 08/16/17
3D Lap. surgery @ Keck USC, Dr. Sang Lee 10/17/17 temp ileostomy
11/1 hospitalized abscess/hernia - home 11/06/17 antibiotics
NO LYMPHS INVOLVED! NEAR PATHOLOGICAL RESPONSE! YAY! :shock:
Took her last chemo med 05/10/18! Ileo reversal 07/24/18
1st BM after reversal 07/25/18 Anal Fissure 8/15/18
Me:1st Colonoscopy age 38. 08/17 Benign polp.

Beckster
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Joined: Thu Jan 12, 2017 3:01 pm
Location: New Jersey

Re: Xeloda-induced diarrhea

Postby Beckster » Wed Nov 08, 2017 5:12 am

Faithandpeace wrote:My husband started Xeloda two weeks ago. Two weeks on then one week off. Toward the end of the first two weeks, he started getting diarrhea 3-4 times a day. It really exhausted him. The pharmacist told him to take Imodium.

Has anyone successfully treated Xeloda-induced diarrhea with anything natural such as supplements, enzymes, etc? He'd rather not take Imodium.

Thank you.


Oh yea...that's me! was on Xeloda for 6 months. The last 2 days of the 2 weeks, I had diarrhea. Immodium worked. By the end of the 2 treatments, I would go to the bathroom up to 10 times a day. Just to let you know, as the treatment progresses...the cumulative effects will make him have more diarrhea.
57/Female
DX:(CC) 10/19/16
11/4/16- Lap right hemi(cecum)
CEA- Pre Op (1.9), Pre Chemo (2.5)
Type: Adenocarcinoma
Tumor size: 3.5 cm x 2.5 x 0.7 cm
Grade: G3 (surgical) G2 (pre-op)
TNM: T3N0M0/IIA
LN: 0/24
LVI present
Surgical margins: clear
MSS
12/27/2016 - Capeox, anaphylactic reaction to oxaliplatin on first infusion-discontinued
1/2/17 to 6/9/17- Xeloda monotherapy
6/17, 12/17, 6/18, 12/18 CT Scan NED :D
CEA- 6/17- 3.6, 9/17- 2.8 12/17-2.8, 3/18-3.1, 6/18-3.0, 9/18 2.8, 12/18 2.5
Clear Colonoscopy 10/17 :D

mpbser
Posts: 512
Joined: Wed Apr 19, 2017 11:52 am

Re: Xeloda-induced diarrhea

Postby mpbser » Wed Nov 08, 2017 5:28 am

My husband is on Xeloda (and Oxi-). He has diarrhea from it that is occasionally worse than normal. His bowel movements have only been solid a few times since his colon surgeries this past spring and summer. His doctors recommended Metamucil to bulk up when he was having issues. I was surprised because I had always associated it as a remedy for constipation, but apparently it has other purposes:

Metamucil is a brand name of psyllium fiber used to treat constipation and diarrhea. Soluble fiber absorbs water in the digestive tract and swells, adding more bulk to your stool. Diarrhea consists of frequent, watery stools that lack bulk.

He bought a sugar free brand, and it's essentially a natural remedy. It has worked well for him.
Wife 4/17 Dx age 45
5/17 - Lap left hemi
Adenocarcinoma
5 x 4 x 1 cm
low grade
T3 N2b M1a
Stage IV A
lymph nodes: 9 of 54
8/17 Sub-total colectomy
2nd tumor 5.5 cm T1 N0
CEA: 1.4, 2.1, 1.5, 1.9, 1.9, 2.1, 2.1, 2.4, 1.7, 2.0
MSS/MSI-L
Lynch no; KRAS wild
Immunohistochemsistry: Normal MLH1, MSH2, MSH6, and PMS2
Tumor DNA variants: MTOR, APC, TP53
Liver left hepatectomy seg 4 1/31/18
5/18 NED

rp1954
Posts: 1393
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Re: Xeloda-induced diarrhea

Postby rp1954 » Wed Nov 08, 2017 6:27 am

If the diarrhea is associated with damaged villi and mucosa then it might be partly a toxicity question and a question of supplements for GI healing. Although dosage is the easy blame, some drugs or folic acid can magnify 5FU or Xeloda's toxicity. We used supplements like glutamine, vitamin C, zinc carnosine, glucosamine and niacinamide for folic acid - 5FU GI damage. Historically, large mounts of cabbage juice was used by Prof Lester Morrison for GI damage too.

For failures of digestion (loss of PE or HCl, infection related?), some CRC patients cleared their diarrhea with pancreatic enzymes(PE).
watchful, active researcher and caregiver for stage IVb/c CC since early 2010. 8 yrs immuno-Chemo for mCRC, now no chemo
most of 2010 Life Extension recommendations and possibilities + more, some (much) higher

Faithandpeace
Posts: 22
Joined: Thu Aug 17, 2017 12:25 pm
Location: California

Re: Xeloda-induced diarrhea

Postby Faithandpeace » Wed Nov 08, 2017 10:49 am

Beckster wrote:
Oh yea...that's me! was on Xeloda for 6 months. The last 2 days of the 2 weeks, I had diarrhea. Immodium worked. By the end of the 2 treatments, I would go to the bathroom up to 10 times a day. Just to let you know, as the treatment progresses...the cumulative effects will make him have more diarrhea.


Beckster, it's good to know my husband's experience isn't unique, but even with Imodium you still had bouts of diarrhea 10 times a day?! Yikes! Hubby needs to work and these bouts exhaust him!
DH dx 12/16, age 56, stage IV, mets to liver and lungs
5 tx Folfox + Avastin + clinical trial, 1/17-3/17, good results
Immunotherapy in Germany + 3 TACE, 2 TPCE (3/17-6/17)
Folfox + Avastin 8/17, 4 tx
10/17 xeloda + Avastin
12/17 PET negative in liver and lungs. Primary tumor thriving
1/6/18 LAR, temp loop ileostomy, horrible complications, 10 weeks in hospital, still recovering, 4/18.
4/30/18: Y90 to left lobe of liver
6/18: ablations to liver + lung mets

Faithandpeace
Posts: 22
Joined: Thu Aug 17, 2017 12:25 pm
Location: California

Re: Xeloda-induced diarrhea

Postby Faithandpeace » Wed Nov 08, 2017 10:51 am

mpbser wrote:My husband is on Xeloda (and Oxi-). He has diarrhea from it that is occasionally worse than normal. His bowel movements have only been solid a few times since his colon surgeries this past spring and summer. His doctors recommended Metamucil to bulk up when he was having issues. I was surprised because I had always associated it as a remedy for constipation, but apparently it has other purposes:

Metamucil is a brand name of psyllium fiber used to treat constipation and diarrhea. Soluble fiber absorbs water in the digestive tract and swells, adding more bulk to your stool. Diarrhea consists of frequent, watery stools that lack bulk.

He bought a sugar free brand, and it's essentially a natural remedy. It has worked well for him.


Thank you, we will check into psyllium husk fiber. But, you are right, sounds so counterintuitive!
DH dx 12/16, age 56, stage IV, mets to liver and lungs
5 tx Folfox + Avastin + clinical trial, 1/17-3/17, good results
Immunotherapy in Germany + 3 TACE, 2 TPCE (3/17-6/17)
Folfox + Avastin 8/17, 4 tx
10/17 xeloda + Avastin
12/17 PET negative in liver and lungs. Primary tumor thriving
1/6/18 LAR, temp loop ileostomy, horrible complications, 10 weeks in hospital, still recovering, 4/18.
4/30/18: Y90 to left lobe of liver
6/18: ablations to liver + lung mets

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peanut_8
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Location: Capital of Texas

Re: Xeloda-induced diarrhea

Postby peanut_8 » Wed Nov 08, 2017 11:49 am

Diarrhea is a common side effect of Xeloda. It's annoying and can really lead to being dehydrated. You could try Kaopectate, It's active ingredient is Bismuth subsalicylate.

If diarrhea is severe, your physician may prescribe a tincture of opium. I had diarrhea during treatment, and used Imodium and Kaopectate. I also made sure to drink lots (2-3 liters) of water daily to flush the crud out my system.

It's possible that you will be unable to end the diarrhea using natural products alone. Keep your physician updated.

Best Wishes,
peanut
Terri aka peanut
diagnosed Jan 14, RC stage 2a, age 56
permanent colostomy
MSS
April 14, 28 chemo/rad with Xeloda
June 14 adjuvant Xeloda 6 rounds
currently NED

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susie0915
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Facebook Username: Susan DeGrazia Hostetter
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Re: Xeloda-induced diarrhea

Postby susie0915 » Wed Nov 08, 2017 1:52 pm

I had diarrhea during chemo as well. My ileostomy was reversed early due to a blockage after my LAR. Doctor had to remove scar tissue so he reversed my ileostomy just five weeks after resection. Made it worse during chemo, but my oncologist also prescribed Questran. It's a powder you can mix with water or juice. It is originally used for cholesterol but it helps with diarrhea also. It worked pretty well for me. I also took lomotil and immodium. You may want to ask your oncologist. If diarrhea gets too bad he may need to go in for hydration and have potassium checked as well. Make sure he eats bananas and potatoes they are good for potassium. He may want to follow a brat diet. (bananas, white rice, applesauce, and dry toast). These foods help for diarrhea. That was helpful as well.
58 yrs old Dx @ 55
5/15 DX T3N0MO
6/15 5 wks chemo/rad
7/15 sigmoidoscopy/only scar tissue left
8/15 Pet scan NED
9/15 LAR
0/24 nodes
10/15 Bowel blockage. surgery,early ileo rev, c-diff inf :(
12/15 6 rds of xelox
5/16 Clear CT lung scarring/inflammation
9/16 clear colonoscopy
4/17 CT 4mm lung nod
7/17 no change lung nod
10/17 Clear pel/abd CT
11/17 CEA<.5
1/18 CT/Lung no change in 4mm nodule
5/18 CEA<.5, clear CT pel/abd/lung nod no change
11/18 CEA .6

zephyr
Posts: 142
Joined: Thu Aug 18, 2016 7:31 am

Re: Xeloda-induced diarrhea

Postby zephyr » Wed Nov 08, 2017 3:52 pm

I'm not on Xeloda but I've had issues with diarrhea from a trashed gastrointestinal system. Imodium worked well but it ended up over-correcting for me, and then I had constipation, and it went downhill from there. After trying about everything suggested, rice congee did the trick for me. It was suggested by the dietician at the cancer center. You can find directions online but the simple version is: 1 cup long-cooking white rice (no Minute Rice) and 6-7 parts fluid (water, chicken broth, vegetable broth), then cook on the stovetop for 40-45 minutes. I would eat it plain or add some to vegetable soup. Another thing, no raw veggies or fruits, only cooked. I also take psyllium everyday and have for years. It all helps but the rice congee was my turning point.
Nov-2009 Early stage CRC found during routine colonoscopy
2010, 2011, 2014 Follow up colonoscopies, all clear
Jun-2016 CRC found during routine follow up colonoscopy, surgery, Stage 4, KRAS, inoperable lung mets
Aug-2016-May-2018 Folfox, 5FU & Avastin, 5FU, Folfiri & Cyramza
Aug/Sep-2018 YAG laser surgeries (Germany) on both lungs, 11 nodules (9 mets) removed

Faithandpeace
Posts: 22
Joined: Thu Aug 17, 2017 12:25 pm
Location: California

Re: Xeloda-induced diarrhea

Postby Faithandpeace » Wed Nov 08, 2017 5:28 pm

rp1954 wrote:If the diarrhea is associated with damaged villi and mucosa then it might be partly a toxicity question and a question of supplements for GI healing. Although dosage is the easy blame, some drugs or folic acid can magnify 5FU or Xeloda's toxicity. We used supplements like glutamine, vitamin C, zinc carnosine, glucosamine and niacinamide for folic acid - 5FU GI damage. Historically, large mounts of cabbage juice was used by Prof Lester Morrison for GI damage too.

For failures of digestion (loss of PE or HCl, infection related?), some CRC patients cleared their diarrhea with pancreatic enzymes(PE).


Thank you, rp1954, I am still actively searching for an integrative physician to help us with all this. You sound as if you have a medical background...I certainly do not so it's a VERY steep learning curve for me. But, I won't give up until I find what we need. This forum is so very helpful!
DH dx 12/16, age 56, stage IV, mets to liver and lungs
5 tx Folfox + Avastin + clinical trial, 1/17-3/17, good results
Immunotherapy in Germany + 3 TACE, 2 TPCE (3/17-6/17)
Folfox + Avastin 8/17, 4 tx
10/17 xeloda + Avastin
12/17 PET negative in liver and lungs. Primary tumor thriving
1/6/18 LAR, temp loop ileostomy, horrible complications, 10 weeks in hospital, still recovering, 4/18.
4/30/18: Y90 to left lobe of liver
6/18: ablations to liver + lung mets

Faithandpeace
Posts: 22
Joined: Thu Aug 17, 2017 12:25 pm
Location: California

Re: Xeloda-induced diarrhea

Postby Faithandpeace » Wed Nov 08, 2017 5:30 pm

zephyr wrote:I'm not on Xeloda but I've had issues with diarrhea from a trashed gastrointestinal system. Imodium worked well but it ended up over-correcting for me, and then I had constipation, and it went downhill from there. After trying about everything suggested, rice congee did the trick for me. It was suggested by the dietician at the cancer center. You can find directions online but the simple version is: 1 cup long-cooking white rice (no Minute Rice) and 6-7 parts fluid (water, chicken broth, vegetable broth), then cook on the stovetop for 40-45 minutes. I would eat it plain or add some to vegetable soup. Another thing, no raw veggies or fruits, only cooked. I also take psyllium everyday and have for years. It all helps but the rice congee was my turning point.


I'm going to try that rice congee. Did you eat it with meals or just at regular intervals or only after you had a bout of diarrhea?
DH dx 12/16, age 56, stage IV, mets to liver and lungs
5 tx Folfox + Avastin + clinical trial, 1/17-3/17, good results
Immunotherapy in Germany + 3 TACE, 2 TPCE (3/17-6/17)
Folfox + Avastin 8/17, 4 tx
10/17 xeloda + Avastin
12/17 PET negative in liver and lungs. Primary tumor thriving
1/6/18 LAR, temp loop ileostomy, horrible complications, 10 weeks in hospital, still recovering, 4/18.
4/30/18: Y90 to left lobe of liver
6/18: ablations to liver + lung mets

Faithandpeace
Posts: 22
Joined: Thu Aug 17, 2017 12:25 pm
Location: California

Re: Xeloda-induced diarrhea

Postby Faithandpeace » Wed Nov 08, 2017 5:32 pm

Thank you peanut_8 and susie0915, these are all helpful suggestions.
DH dx 12/16, age 56, stage IV, mets to liver and lungs
5 tx Folfox + Avastin + clinical trial, 1/17-3/17, good results
Immunotherapy in Germany + 3 TACE, 2 TPCE (3/17-6/17)
Folfox + Avastin 8/17, 4 tx
10/17 xeloda + Avastin
12/17 PET negative in liver and lungs. Primary tumor thriving
1/6/18 LAR, temp loop ileostomy, horrible complications, 10 weeks in hospital, still recovering, 4/18.
4/30/18: Y90 to left lobe of liver
6/18: ablations to liver + lung mets

zephyr
Posts: 142
Joined: Thu Aug 18, 2016 7:31 am

Re: Xeloda-induced diarrhea

Postby zephyr » Wed Nov 08, 2017 6:46 pm

Faithandpeace wrote:
zephyr wrote:I'm not on Xeloda but I've had issues with diarrhea from a trashed gastrointestinal system. Imodium worked well but it ended up over-correcting for me, and then I had constipation, and it went downhill from there. After trying about everything suggested, rice congee did the trick for me. It was suggested by the dietician at the cancer center. You can find directions online but the simple version is: 1 cup long-cooking white rice (no Minute Rice) and 6-7 parts fluid (water, chicken broth, vegetable broth), then cook on the stovetop for 40-45 minutes. I would eat it plain or add some to vegetable soup. Another thing, no raw veggies or fruits, only cooked. I also take psyllium everyday and have for years. It all helps but the rice congee was my turning point.


I'm going to try that rice congee. Did you eat it with meals or just at regular intervals or only after you had a bout of diarrhea?


I eat it as needed. You can leave it in the frig for a few days and heat it up in small batches. As the diarrhea starts, I eat a little rice congee here and there throughout the day. I'm often too exhausted to have much appetite so I graze on plain congee, bananas, unsweetened organic applesauce, toast (white breads only), and vegetable soups or broths with a good helping of rice congee tossed in. Rice congee is the main thing and I try to eat as much as I can because I know it will help. The diarrhea usually turns around for me within hours, and no more constipation, fissures, etc.

I also drink coconut water during bouts of diarrhea to keep from getting dehydrated. I personally don't like the sports drinks - they all seem too sweet to me, and the chemo nurses suggested coconut water as a good hydration solution without additives. I don't know if it's true but I've read that not all coconut waters are created equal and that those in the refrigerated section are more pure or something. I buy the Harmless Harvest brand at Costco. If you try it, make sure to check the expiration date because they only seem to be good for 1-2 weeks.

While you're at Costco, pick up a 2-pack of rubber gloves and the Desitin diaper cream. Both are over by the pharmacy.

If you want a good recipe for healing broth, don't hesitate to PM me.

Probably more that you wanted to know ... but I hope it helps.

Edited to add: I made this last night after a few hours of what was turning into a flare up. I've always been afraid to add anything for flavor because I didn't want to mess with a successful solution. Butt ... last night I just needed something more so I added a tiny amount of butter. It made the rice more inviting and it still worked like a charm.
Nov-2009 Early stage CRC found during routine colonoscopy
2010, 2011, 2014 Follow up colonoscopies, all clear
Jun-2016 CRC found during routine follow up colonoscopy, surgery, Stage 4, KRAS, inoperable lung mets
Aug-2016-May-2018 Folfox, 5FU & Avastin, 5FU, Folfiri & Cyramza
Aug/Sep-2018 YAG laser surgeries (Germany) on both lungs, 11 nodules (9 mets) removed

Faithandpeace
Posts: 22
Joined: Thu Aug 17, 2017 12:25 pm
Location: California

Re: Xeloda-induced diarrhea

Postby Faithandpeace » Tue Nov 14, 2017 1:41 am

Thank you, Zephyr, all good suggestions. After the diarrhea started, my husband also got blood blisters on his hand, extreme fatigue and, the icing on the cake, painful mouth sores. The onc told him to wait another week before starting back on Xeloda and then to reduce the dosage. We will see if it gets better.
DH dx 12/16, age 56, stage IV, mets to liver and lungs
5 tx Folfox + Avastin + clinical trial, 1/17-3/17, good results
Immunotherapy in Germany + 3 TACE, 2 TPCE (3/17-6/17)
Folfox + Avastin 8/17, 4 tx
10/17 xeloda + Avastin
12/17 PET negative in liver and lungs. Primary tumor thriving
1/6/18 LAR, temp loop ileostomy, horrible complications, 10 weeks in hospital, still recovering, 4/18.
4/30/18: Y90 to left lobe of liver
6/18: ablations to liver + lung mets


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