Diarrhea and bloating and gas, oh my!

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Jacques
Posts: 497
Joined: Sun Dec 28, 2014 10:38 am
Location: Occitanie

Re: Diarrhea and bloating and gas, oh my!

Postby Jacques » Thu Aug 15, 2019 10:03 pm

TinaFish wrote:...They're prescribing me metformin, doxycycline, mebendazole, and atorvastatin...

TinaFish -
Are you still taking the four-drug cocktail that was prescribed for you earlier? If so, you should check on how all of these drugs interact with your current CAPEOX + Avastin regimen. I think this was suggested earlier by CRguy.

Does your oncologist know that you have a prescription from outside for these four other medications?

Drug-Drug Interaction Report

( Click on "Check for Interactions" in the above link. )

TinaFish
Posts: 178
Joined: Sun Jul 21, 2019 10:11 am

Re: Diarrhea and bloating and gas, oh my!

Postby TinaFish » Thu Aug 15, 2019 11:45 pm

boxhill wrote:I don't know what you are taking metformin for, but if you could reduce your dose that might help reduce diarrhea. Also, if you split your dose between morning and evening with the larger dose in the evening it might help.

Meantime, I'm not familiar with the anti-diarrhea drugs you are taking, but with immodium it is clear that you don't take the opening dose until you have had one loose stool, then you take one more if you have another loose stool, and so forth.


Care Oncology prescribed me Metformin, atorvastatin, mebendazole, and doxycycline in order to block my tumors' pathways. I do split my dose, but it's two pills. I guess I could cut a piece off of one and take more at night? I would hate to be kept awake by diarrhea all night long.

You're right about Imodium - I should take it as it's recommended to be taken; not proactively. It was just that my second round of chemo had such horrific side effects. I was having diarrhea come out literally every 15 minutes. Changing my underwear every 15 minutes. And I had to lie down otherwise, because if I stood up at all, the diarrhea was even more frequent. My skin was so sore from being wiped so frequently. So you can probably understand my effort to prevent all of that the 3rd time around. I did prevent it, haha! I was just miserable with bloating and cramps!
F 45, single mother to son, 7 and daughter, 3
DX: stage 4 Rectal Cancer June 2019
Tumor Location: ? cm above anal verge
Tumor type: Adenocarcinoma
Tumor size: 5 cm
Tumor grade: ?
TNM code: ?
Stage : Stage IV-B
# of cancerous lymph nodes: ?
Mets: Numerous mets to liver, lungs
CEA: 22 in July; 11 as of August 15, 7 as of Sept 20
MSI status: MSS
KRAS/BRAF status: KRAS mutation
surgery: TBD
Ostomy surgery: TBD
Radiation therapy: TBD
Chemotherapy : CAPEOX+Avastin, 6 cycles, with CT scans after 3rd and 6th cycle.

TinaFish
Posts: 178
Joined: Sun Jul 21, 2019 10:11 am

Re: Diarrhea and bloating and gas, oh my!

Postby TinaFish » Thu Aug 15, 2019 11:48 pm

Jacques wrote:
TinaFish wrote:...They're prescribing me metformin, doxycycline, mebendazole, and atorvastatin...

TinaFish -
Are you still taking the four-drug cocktail that was prescribed for you earlier? If so, you should check on how all of these drugs interact with your current CAPEOX + Avastin regimen. I think this was suggested earlier by CRguy.

Does your oncologist know that you have a prescription from outside for these four other medications?

Drug-Drug Interaction Report

( Click on "Check for Interactions" in the above link. )


Yes, I am. I gave my oncologist the complete list of all meds that I'm taking. She said everything looked fine. I asked about any contraindications between cimetidine and... which one was it? Either metformin and atorvastatin. She said that we're testing my blood so frequently that if anything were to go badly, it would happen slowly and we'd see it right away in blood test results.
F 45, single mother to son, 7 and daughter, 3
DX: stage 4 Rectal Cancer June 2019
Tumor Location: ? cm above anal verge
Tumor type: Adenocarcinoma
Tumor size: 5 cm
Tumor grade: ?
TNM code: ?
Stage : Stage IV-B
# of cancerous lymph nodes: ?
Mets: Numerous mets to liver, lungs
CEA: 22 in July; 11 as of August 15, 7 as of Sept 20
MSI status: MSS
KRAS/BRAF status: KRAS mutation
surgery: TBD
Ostomy surgery: TBD
Radiation therapy: TBD
Chemotherapy : CAPEOX+Avastin, 6 cycles, with CT scans after 3rd and 6th cycle.

TinaFish
Posts: 178
Joined: Sun Jul 21, 2019 10:11 am

Re: Diarrhea and bloating and gas, oh my!

Postby TinaFish » Fri Aug 16, 2019 4:51 am

Rock_Robster wrote:
TinaFish wrote:I don't know if I can stop the cramping, but it would be nice to not be on the toilet so often. By some miracle

Hi TinaFish, is Buscopan (hyoscine butylbromide) available where you are? I find one dose of this very effective for stomach cramps.


Are you f****** kidding me?? I tried Buscopan for the first time about six hours ago, and I'm awe-struck! It worked almost instantly after I took it, and I feel great!! No more pain, no more cramps, no more gas, diarrhea is significantly better, no more tenesmus, omg, I think this medicine is made by angels and sent down from heaven! I haven't felt this good in months!! Thank you so much, Rock_Robster!! It's been a long time since I've caught myself forgetting that I have cancer! I've forgotten about it numerous times tonight! Life is so much better when you don't have a constant reminder that you're sick!! You know what's sick? The fact that you can't buy Buscopan in the U.S.!
F 45, single mother to son, 7 and daughter, 3
DX: stage 4 Rectal Cancer June 2019
Tumor Location: ? cm above anal verge
Tumor type: Adenocarcinoma
Tumor size: 5 cm
Tumor grade: ?
TNM code: ?
Stage : Stage IV-B
# of cancerous lymph nodes: ?
Mets: Numerous mets to liver, lungs
CEA: 22 in July; 11 as of August 15, 7 as of Sept 20
MSI status: MSS
KRAS/BRAF status: KRAS mutation
surgery: TBD
Ostomy surgery: TBD
Radiation therapy: TBD
Chemotherapy : CAPEOX+Avastin, 6 cycles, with CT scans after 3rd and 6th cycle.

Rock_Robster
Posts: 288
Joined: Thu Oct 25, 2018 5:27 am
Location: Melbourne, Australia

Re: Diarrhea and bloating and gas, oh my!

Postby Rock_Robster » Fri Aug 16, 2019 6:27 am

TinaFish wrote:
Rock_Robster wrote:
TinaFish wrote:I don't know if I can stop the cramping, but it would be nice to not be on the toilet so often. By some miracle

Hi TinaFish, is Buscopan (hyoscine butylbromide) available where you are? I find one dose of this very effective for stomach cramps.


Thank you so much, Rock_Robster!! It's been a long time since I've caught myself forgetting that I have cancer! I've forgotten about it numerous times tonight! Life is so much better when you don't have a constant reminder that you're sick!! You know what's sick? The fact that you can't buy Buscopan in the U.S.!

Hi TinaFish, I’m so glad this could give you some modest relief in the midst of everything you’re going through!

Buscopan is a very old drug with (as far as I’m aware) a pretty good safety profile, so I’m surprised it’s not more widely available. From what I can tell, it’s widely available in Canada, the UK and Australia, but for some reason not in the US. They actually also use it sometimes here with CT scans via IV to slow motility of the intestines to give better imaging.

Hope things continue to improve for you.
Male 37; Melbourne, Australia
10/2018 Dx 3.5cm RC adenocarcinoma, 12cm from AV
Mod diff, EMVI+ LVI+ PNI-
3 LN; 4 liver mets, resectable
pT3pN1apM1a; Stage IVa. MSS, NRAS (G13R)
CEA: Oct-18= 12; Nov-18= 14, Mar-19= 2.4, Aug-19 <2.0
11/18 - FOLFOX x 6
3/19 - Liver resection
4-5/19 - 25 x pelvic radiation; complete met. response, TRG 3
07/19 - ULAR (robot), temp ileo, 1/27 LN+
08/19 - Missed liver spot
08/19 - FOLFOX x 1, FOLFOXIRI x 1, FOLFIRI x 2
10/19 - Planned liver resection #2 & ileo reversal

NHMike
Posts: 2204
Joined: Fri Jul 21, 2017 3:43 am

Re: Diarrhea and bloating and gas, oh my!

Postby NHMike » Fri Aug 16, 2019 6:51 am

Glad that you found a solution. There is a similar drug in the US and I assume that’s what people use here.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8, 2/12 1.2
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal
2/19: Clean CT

TinaFish
Posts: 178
Joined: Sun Jul 21, 2019 10:11 am

Re: Diarrhea and bloating and gas, oh my!

Postby TinaFish » Fri Aug 16, 2019 10:53 am

NHMike wrote:Glad that you found a solution. There is a similar drug in the US and I assume that’s what people use here.


What is the similar drug?
F 45, single mother to son, 7 and daughter, 3
DX: stage 4 Rectal Cancer June 2019
Tumor Location: ? cm above anal verge
Tumor type: Adenocarcinoma
Tumor size: 5 cm
Tumor grade: ?
TNM code: ?
Stage : Stage IV-B
# of cancerous lymph nodes: ?
Mets: Numerous mets to liver, lungs
CEA: 22 in July; 11 as of August 15, 7 as of Sept 20
MSI status: MSS
KRAS/BRAF status: KRAS mutation
surgery: TBD
Ostomy surgery: TBD
Radiation therapy: TBD
Chemotherapy : CAPEOX+Avastin, 6 cycles, with CT scans after 3rd and 6th cycle.

boxhill
Posts: 336
Joined: Fri Apr 06, 2018 11:40 am

Re: Diarrhea and bloating and gas, oh my!

Postby boxhill » Sat Aug 17, 2019 3:46 pm

Metformin is usually prescribed for T2 diabetes, and it is NOTORIOUS for causing diarrhea, and in some cases a lot of gas!!!!!! It has been nicknamed Metfartin. Metformin probably isn't going to do anything involving your tumor's "pathways," what it does is discourage the liver from dumping glucose into the blood, thus helping to control blood glucose levels. It would appear that they are prescribing this to you on the theory that blood sugar feeds cancer.

That's all very well and good, but I can assure you that I would not be taking it if I didn't actually need it to help control my BG because of T2, because DIARRHEA. For YEARS. What dose are you taking? MANY, and I mean MANY people can't tolerate it.

What is the rationale for taking atorvastatin? Do you have high cholesterol? What dose are you taking? What is the rationale for taking an antibiotic? Both of those drugs have diarrhea as a common side effect. I've read about the worm med guy. It's not clear to me whether his personal results have been duplicated or studied seriously. I wouldn't dismiss it, but...

Your onc may have cast an eye over this list and decided that if you wanted to try it it would be unlikely to do you any serious harm, since they are doing frequent blood tests, as one must on chemo.

But given the extreme nature of your diarrhea, I think you should immediately quit taking metformin, at least. If you want to control your BG levels, get a testing kit and start limiting your carbs. Metformin is also somewhat of an issue for those having scans with contrast, since the combo can put a strain on the kidneys.

What you are doing is piling more and more drugs into your system, all of which have to be dealt with by your liver and kidneys. I seriously think you should rethink this.
F, 64 at DX CRC Stage IV
3/17/18 blockage, r hemi
11 of 25 nodes,5 mesentery nodes
5mm liver met out
pT3 pN2b pM1
BRAF wild, KRAS G12D
dMMR, MSI-H
5/4/18 FOLFOX
Neulasta 6/28
7/9/18 CT NED
11/20/18 CT NED. Enlarged spleen.
12/20/18 Liver MRI 5mm liver met? and 2 lymph nodes in porta hepatis
12/31/18 Keytruda
6/5/19 Triphasic CT LN and spleen normal, Liver node stable
6/28/19 Pause Keytruda, predisone for joint pain
7/31/19 Restart Keytruda
9/10/19 CT stable

TinaFish
Posts: 178
Joined: Sun Jul 21, 2019 10:11 am

Re: Diarrhea and bloating and gas, oh my!

Postby TinaFish » Sat Aug 17, 2019 4:25 pm

boxhill wrote:Metformin is usually prescribed for T2 diabetes, and it is NOTORIOUS for causing diarrhea, and in some cases a lot of gas!!!!!! It has been nicknamed Metfartin. Metformin probably isn't going to do anything involving your tumor's "pathways," what it does is discourage the liver from dumping glucose into the blood, thus helping to control blood glucose levels. It would appear that they are prescribing this to you on the theory that blood sugar feeds cancer.[\quote]

[quote=Tina"]Lol @ metfartin! I'm taking 500mg in the morning and 500mg in the evening. I probably should stop taking it, at least for a while, to see if my diarrhea gets better. Do you know how long it takes to get out of your system? I wish there was a definitive consensus on whether blood sugar feeds cancer.[\quote]

boxhill wrote:That's all very well and good, but I can assure you that I would not be taking it if I didn't actually need it to help control my BG because of T2, because DIARRHEA. For YEARS. What dose are you taking? MANY, and I mean MANY people can't tolerate it.

What is the rationale for taking atorvastatin? Do you have high cholesterol? What dose are you taking? What is the rationale for taking an antibiotic? Both of those drugs have diarrhea as a common side effect. I've read about the worm med guy. It's not clear to me whether his personal results have been duplicated or studied seriously. I wouldn't dismiss it, but...[\quote]

Statins inhibit the growth of cancer cells in vitro, but I forgot Care Oncology's specific reason for implementing atorvastatin. I do not have high cholesterol. When I showed my list of meds to my radiologist, he commented that it's very good for your heart to take a statin. As far as the antibiotic (doxycyclene) it's technically a protocol whereby I take mebendazole 111mg once a day for 30 days, followed by doxycycline 100mg once a day for 30 days, alternating between the two meds. I'm on like day 20 of the 30 days mebendazole, so I haven't started the doxycycline yet. I don't know who the worm med guy is, but I guess you're referring to Mebendazole.

The Care Oncology protocol is based upon the idea of treating cancer metabolically. I am in no way educated enough to know whether this is a viable protocol, but I figured as long as it's not detrimental, I should incorporate it.

boxhill wrote:Your onc may have cast an eye over this list and decided that if you wanted to try it it would be unlikely to do you any serious harm, since they are doing frequent blood tests, as one must on chemo.

But given the extreme nature of your diarrhea, I think you should immediately quit taking metformin, at least. If you want to control your BG levels, get a testing kit and start limiting your carbs. Metformin is also somewhat of an issue for those having scans with contrast, since the combo can put a strain on the kidneys.

What you are doing is piling more and more drugs into your system, all of which have to be dealt with by your liver and kidneys. I seriously think you should rethink this.


I think you're giving good advice. The diarrhea has become very difficult to live with. All along, I had been blaming the chemo, but maybe my blame was misplaced. I could monitor BG all day long, but the fact remains I've lost like 20 lbs in two months, and I'm very scared of losing more weight. When an idea pops into my head about a food that I could possibly tolerate, I eat it right away. I don't care what it is. Because nothing is appetizing these days, and together with the diarrhea causing me not to absorb enough nutrition and calories, I'm in a dangerous position.

Liver and kidneys, yes, absolutely. My concern as well. But the oncologist said that my list of meds was fine. Still, if the Care Oncology meds are causing diarrhea, then they must be stopped.

Edit: my HTML-editing skills are obviously lacking in this reply, lol, but you can see what I was trying to do. I'm disappointed in myself! I thought I knew how to do this! I've been editing code for 20 years, lol!
Last edited by TinaFish on Sat Aug 17, 2019 4:42 pm, edited 1 time in total.
F 45, single mother to son, 7 and daughter, 3
DX: stage 4 Rectal Cancer June 2019
Tumor Location: ? cm above anal verge
Tumor type: Adenocarcinoma
Tumor size: 5 cm
Tumor grade: ?
TNM code: ?
Stage : Stage IV-B
# of cancerous lymph nodes: ?
Mets: Numerous mets to liver, lungs
CEA: 22 in July; 11 as of August 15, 7 as of Sept 20
MSI status: MSS
KRAS/BRAF status: KRAS mutation
surgery: TBD
Ostomy surgery: TBD
Radiation therapy: TBD
Chemotherapy : CAPEOX+Avastin, 6 cycles, with CT scans after 3rd and 6th cycle.

TinaFish
Posts: 178
Joined: Sun Jul 21, 2019 10:11 am

Re: Diarrhea and bloating and gas, oh my!

Postby TinaFish » Sat Aug 17, 2019 4:34 pm

Yep, just googled things and EVERY ONE of the meds from Care Oncology causes diarrhea and stomach upset. I'm quitting now. At least temporarily. Once again, great advice on this forum. Thank you, Boxhill.

Omg, Metformin also causes weight loss!

I find it weird that no one else on this site has signed up with Care Oncology!
F 45, single mother to son, 7 and daughter, 3
DX: stage 4 Rectal Cancer June 2019
Tumor Location: ? cm above anal verge
Tumor type: Adenocarcinoma
Tumor size: 5 cm
Tumor grade: ?
TNM code: ?
Stage : Stage IV-B
# of cancerous lymph nodes: ?
Mets: Numerous mets to liver, lungs
CEA: 22 in July; 11 as of August 15, 7 as of Sept 20
MSI status: MSS
KRAS/BRAF status: KRAS mutation
surgery: TBD
Ostomy surgery: TBD
Radiation therapy: TBD
Chemotherapy : CAPEOX+Avastin, 6 cycles, with CT scans after 3rd and 6th cycle.

NHMike
Posts: 2204
Joined: Fri Jul 21, 2017 3:43 am

Re: Diarrhea and bloating and gas, oh my!

Postby NHMike » Sat Aug 17, 2019 5:19 pm

TinaFish wrote:Yep, just googled things and EVERY ONE of the meds from Care Oncology causes diarrhea and stomach upset. I'm quitting now. At least temporarily. Once again, great advice on this forum. Thank you, Boxhill.

Omg, Metformin also causes weight loss!

I find it weird that no one else on this site has signed up with Care Oncology!


I had never heard of them before so I looked them up. I'm still not exactly sure how they work but the general idea has been discussed on this board. There are some drugs that aren't designed to treat cancer but there has been some small amount of research indicating that they can help. Some people here use them. I can't really judge the efficacy of this approach though.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8, 2/12 1.2
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal
2/19: Clean CT

Jacques
Posts: 497
Joined: Sun Dec 28, 2014 10:38 am
Location: Occitanie

Re: Diarrhea and bloating and gas, oh my!

Postby Jacques » Sat Aug 17, 2019 11:51 pm

Tina - Is this what you were trying to display in your previous post?
- - - -
    boxhill wrote:Metformin is usually prescribed for T2 diabetes, and it is NOTORIOUS for causing diarrhea, and in some cases a lot of gas!!!!!! It has been nicknamed Metfartin. Metformin probably isn't going to do anything involving your tumor's "pathways," what it does is discourage the liver from dumping glucose into the blood, thus helping to control blood glucose levels. It would appear that they are prescribing this to you on the theory that blood sugar feeds cancer.


    Lol @ metfartin! I'm taking 500mg in the morning and 500mg in the evening. I probably should stop taking it, at least for a while, to see if my diarrhea gets better. Do you know how long it takes to get out of your system? I wish there was a definitive consensus on whether blood sugar feeds cancer.

    boxhill wrote:That's all very well and good, but I can assure you that I would not be taking it if I didn't actually need it to help control my BG because of T2, because DIARRHEA. For YEARS. What dose are you taking? MANY, and I mean MANY people can't tolerate it.

    What is the rationale for taking atorvastatin? Do you have high cholesterol? What dose are you taking? What is the rationale for taking an antibiotic? Both of those drugs have diarrhea as a common side effect. I've read about the worm med guy. It's not clear to me whether his personal results have been duplicated or studied seriously. I wouldn't dismiss it, but...


    Statins inhibit the growth of cancer cells in vitro, but I forgot Care Oncology's specific reason for implementing atorvastatin. I do not have high cholesterol. When I showed my list of meds to my radiologist, he commented that it's very good for your heart to take a statin. As far as the antibiotic (doxycyclene) it's technically a protocol whereby I take mebendazole 111mg once a day for 30 days, followed by doxycycline 100mg once a day for 30 days, alternating between the two meds. I'm on like day 20 of the 30 days mebendazole, so I haven't started the doxycycline yet. I don't know who the worm med guy is, but I guess you're referring to Mebendazole.

    The Care Oncology protocol is based upon the idea of treating cancer metabolically. I am in no way educated enough to know whether this is a viable protocol, but I figured as long as it's not detrimental, I should incorporate it.

    boxhill wrote:Your onc may have cast an eye over this list and decided that if you wanted to try it it would be unlikely to do you any serious harm, since they are doing frequent blood tests, as one must on chemo.

    But given the extreme nature of your diarrhea, I think you should immediately quit taking metformin, at least. If you want to control your BG levels, get a testing kit and start limiting your carbs. Metformin is also somewhat of an issue for those having scans with contrast, since the combo can put a strain on the kidneys.

    What you are doing is piling more and more drugs into your system, all of which have to be dealt with by your liver and kidneys. I seriously think you should rethink this.


    I think you're giving good advice. The diarrhea has become very difficult to live with. All along, I had been blaming the chemo, but maybe my blame was misplaced. I could monitor BG all day long, but the fact remains I've lost like 20 lbs in two months, and I'm very scared of losing more weight. When an idea pops into my head about a food that I could possibly tolerate, I eat it right away. I don't care what it is. Because nothing is appetizing these days, and together with the diarrhea causing me not to absorb enough nutrition and calories, I'm in a dangerous position.

    Liver and kidneys, yes, absolutely. My concern as well. But the oncologist said that my list of meds was fine. Still, if the Care Oncology meds are causing diarrhea, then they must be stopped.

    Edit: my HTML-editing skills are obviously lacking in this reply, lol, but you can see what I was trying to do. I'm disappointed in myself! I thought I knew how to do this! I've been editing code for 20 years, lol!

Jacques
Posts: 497
Joined: Sun Dec 28, 2014 10:38 am
Location: Occitanie

Re: Diarrhea and bloating and gas, oh my!

Postby Jacques » Sun Aug 18, 2019 12:57 am

boxhill wrote:... Metformin is also somewhat of an issue for those having scans with contrast, since the combo can put a strain on the kidneys. ..

Tina -

I think boxhill, is right. If your upcoming CT scan is to be a "CT scan with IV contrast", then your kidney function tests (e.g., BUN, creatinine/creatinine-clearance) all have to be within the normal range before they will give you a prescription for the IV contrast agent. But your upcoming scan really needs to be a "CT scan with IV contrast" so that the fine detail of your liver and lungs will become visible, otherwise there is hardly any point in having a CT scan right now. Right now what you need is a high-definition scan that will show what is going on in you liver and lungs. You can't afford to do anthing now that's going to damage your kidneys.

More information on contrast materials here:

Contrast materials used in CT scans
https://www.radiologyinfo.org/en/info.cfm?pg=safety-contrast


How to Prepare for a CT or CAT Scan
https://www.sjhc.london.on.ca/diagnostic-imaging/ct-computed-tomography-and-cat-computerized-axial-tomography/how-prepare


Possible side effects of an abdominal CT scan

The side effects of an abdominal CT scan are most often caused by a reaction to any contrast used. In most cases, they’re mild. However, if they become more severe, you should call your doctor right away.

Side effects of barium contrast can include:

abdominal cramping
diarrhea
nausea or vomiting
constipation

Side effects of iodine contrast can include:

skin rash or hives
itching
headache

If you’re given either type of contrast and have severe symptoms, call your doctor or go to the emergency room right away.
Ref: https://www.healthline.com/health/abdominal-ct-scan


Alternatives to CT scans. You should be aware that CT scans are not the only kinds of scans used for rectal cancer. Other procedures, such as rectal MRI, or endo-rectal ultrasound (ERUS), can give better, more detailed images of the primary tumor, but they may be more expensive or not ordinarily covered by insurance or not available at small hospitals. (It may be worth asking why they are not using any of these in your case.)

Imaging Rectal Cancer Before Treatment
Before radiation, chemotherapy or surgery for rectal cancer, imaging specialists may use one or more techniques to determine where the tumors are located in the rectum and how far they have spread into surrounding tissue and lymph node. These images help surgeons and radiation oncologists pinpoint exactly where to treat the cancer, how to remove as much of the cancer as possible so that the likelihood of the cancer returning is small, and how to preserve the muscles and nerves of the rectum to give a patient the best quality of life going forward.

Imaging techniques can include:

Rectal protocol MRI: this technique refers to MRI that includes images taken from specific angles to gain the best look at the rectum and surrounding tissue. These images are recommended for patients entering the Johns Hopkins Rectal Cancer Multidisciplinary Clinic.

Transanal ultrasound: transanal ultrasound (TRUS), sometimes called endorectal ultrasound (ERUS), creates images of the rectum from high-energy sound waves produced by a probe inserted through the anus.

Transanal endoscopy ultrasound: transrectal endoscopic ultrasounds (EUS), performed with a flexible endoscope inserted through the anus, are often preferred to transanal ultrasounds to view tumors higher in the rectum, closer to the colon.
Ref: https://www.hopkinsmedicine.org/kimmel_cancer_center/centers/colorectal_cancer/about_rectal_cancer/treatments/radiationtherapy.html

Rock_Robster
Posts: 288
Joined: Thu Oct 25, 2018 5:27 am
Location: Melbourne, Australia

Re: Diarrhea and bloating and gas, oh my!

Postby Rock_Robster » Sun Aug 18, 2019 1:02 am

It sounds like you’re on board with Jacques’ advice anyway TinaFish, but just a short anecdote to support...

Whenever I’ve had extreme reactions to things the first suggestion is always to cut things back and add back in slowly. When I first started chemo I had a pretty horrific reaction - almost like panic attacks, shaking, etc; my onc was stunned. However as I had also just had surgery, I was taking oxycodone, Ativan and ondansetron; in addition to the dexamethasone, Aloxi, metoclopramide, and the chemo drugs. Anyway it turns out there are lots of additive effects between these and I had some sort of mild Serotonin Syndrome. Next round without any opioids and only one anti-nausea drug, and I was fine.

I hope it’s something as simple as this for you!

Rob
Last edited by Rock_Robster on Sun Aug 18, 2019 8:40 am, edited 1 time in total.
Male 37; Melbourne, Australia
10/2018 Dx 3.5cm RC adenocarcinoma, 12cm from AV
Mod diff, EMVI+ LVI+ PNI-
3 LN; 4 liver mets, resectable
pT3pN1apM1a; Stage IVa. MSS, NRAS (G13R)
CEA: Oct-18= 12; Nov-18= 14, Mar-19= 2.4, Aug-19 <2.0
11/18 - FOLFOX x 6
3/19 - Liver resection
4-5/19 - 25 x pelvic radiation; complete met. response, TRG 3
07/19 - ULAR (robot), temp ileo, 1/27 LN+
08/19 - Missed liver spot
08/19 - FOLFOX x 1, FOLFOXIRI x 1, FOLFIRI x 2
10/19 - Planned liver resection #2 & ileo reversal

TinaFish
Posts: 178
Joined: Sun Jul 21, 2019 10:11 am

Re: Diarrhea and bloating and gas, oh my!

Postby TinaFish » Sun Aug 18, 2019 8:36 am

Jacques wrote:Tina - Is this what you were trying to display in your previous post?
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    boxhill wrote:Metformin is usually prescribed for T2 diabetes, and it is NOTORIOUS for causing diarrhea, and in some cases a lot of gas!!!!!! It has been nicknamed Metfartin. Metformin probably isn't going to do anything involving your tumor's "pathways," what it does is discourage the liver from dumping glucose into the blood, thus helping to control blood glucose levels. It would appear that they are prescribing this to you on the theory that blood sugar feeds cancer.


    Lol @ metfartin! I'm taking 500mg in the morning and 500mg in the evening. I probably should stop taking it, at least for a while, to see if my diarrhea gets better. Do you know how long it takes to get out of your system? I wish there was a definitive consensus on whether blood sugar feeds cancer.

    boxhill wrote:That's all very well and good, but I can assure you that I would not be taking it if I didn't actually need it to help control my BG because of T2, because DIARRHEA. For YEARS. What dose are you taking? MANY, and I mean MANY people can't tolerate it.

    What is the rationale for taking atorvastatin? Do you have high cholesterol? What dose are you taking? What is the rationale for taking an antibiotic? Both of those drugs have diarrhea as a common side effect. I've read about the worm med guy. It's not clear to me whether his personal results have been duplicated or studied seriously. I wouldn't dismiss it, but...


    Statins inhibit the growth of cancer cells in vitro, but I forgot Care Oncology's specific reason for implementing atorvastatin. I do not have high cholesterol. When I showed my list of meds to my radiologist, he commented that it's very good for your heart to take a statin. As far as the antibiotic (doxycyclene) it's technically a protocol whereby I take mebendazole 111mg once a day for 30 days, followed by doxycycline 100mg once a day for 30 days, alternating between the two meds. I'm on like day 20 of the 30 days mebendazole, so I haven't started the doxycycline yet. I don't know who the worm med guy is, but I guess you're referring to Mebendazole.

    The Care Oncology protocol is based upon the idea of treating cancer metabolically. I am in no way educated enough to know whether this is a viable protocol, but I figured as long as it's not detrimental, I should incorporate it.

    boxhill wrote:Your onc may have cast an eye over this list and decided that if you wanted to try it it would be unlikely to do you any serious harm, since they are doing frequent blood tests, as one must on chemo.

    But given the extreme nature of your diarrhea, I think you should immediately quit taking metformin, at least. If you want to control your BG levels, get a testing kit and start limiting your carbs. Metformin is also somewhat of an issue for those having scans with contrast, since the combo can put a strain on the kidneys.

    What you are doing is piling more and more drugs into your system, all of which have to be dealt with by your liver and kidneys. I seriously think you should rethink this.


    I think you're giving good advice. The diarrhea has become very difficult to live with. All along, I had been blaming the chemo, but maybe my blame was misplaced. I could monitor BG all day long, but the fact remains I've lost like 20 lbs in two months, and I'm very scared of losing more weight. When an idea pops into my head about a food that I could possibly tolerate, I eat it right away. I don't care what it is. Because nothing is appetizing these days, and together with the diarrhea causing me not to absorb enough nutrition and calories, I'm in a dangerous position.

    Liver and kidneys, yes, absolutely. My concern as well. But the oncologist said that my list of meds was fine. Still, if the Care Oncology meds are causing diarrhea, then they must be stopped.

    Edit: my HTML-editing skills are obviously lacking in this reply, lol, but you can see what I was trying to do. I'm disappointed in myself! I thought I knew how to do this! I've been editing code for 20 years, lol!


Yes :)
F 45, single mother to son, 7 and daughter, 3
DX: stage 4 Rectal Cancer June 2019
Tumor Location: ? cm above anal verge
Tumor type: Adenocarcinoma
Tumor size: 5 cm
Tumor grade: ?
TNM code: ?
Stage : Stage IV-B
# of cancerous lymph nodes: ?
Mets: Numerous mets to liver, lungs
CEA: 22 in July; 11 as of August 15, 7 as of Sept 20
MSI status: MSS
KRAS/BRAF status: KRAS mutation
surgery: TBD
Ostomy surgery: TBD
Radiation therapy: TBD
Chemotherapy : CAPEOX+Avastin, 6 cycles, with CT scans after 3rd and 6th cycle.


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