Updated: Dec 20, 2021
Introduction: In the process of tumor treatment, diarrhea is a very common side effect, which can be seen in chemotherapy, radiotherapy or the latest immunotherapy. According to statistics, 50%-80% of chemotherapy patients and 20%-40% of radiotherapy patients will have diarrhea. The incidence of diarrhea in immunotherapy is also high.
Due to the risk of dehydration and infection, patients with severe tumor treatment-related diarrhea often need to be hospitalized to receive adequate supportive treatment. Other consequences of severe diarrhea include increased treatment costs, decreased quality of life, treatment delays, and decreased compliance with treatment options (if the goal is to cure, this may affect the long-term outcome: life expectancy).
Regular treatment: In terms of medications, there are mainly three categories to choose from: loperamide (Imodium), opium tincture and octreotide. They are mainly used to inhibit gastrointestinal peristalsis or high secretion. But for diarrhea caused by loss of absorptive capacity due to damage of intestinal mucosa, which is actually the main cause of diarrhea in this context, there is no good medicine yet. This kind of passive treatment is not always working, it just waits slowly for the patient's self-recovery. Inhibition of gastrointestinal peristalsis can also produce the side effect of constipation. Often, some patients have too serious diarrhea. Once they are treated with medication, they become severely constipated and need to be hospitalized again.
Treatment of Traditional Chinese Medicine: Generally, Chinese medicine believes that diarrhea in the process of tumor treatment belongs to the invasion of external pathogens: cancer patients are weaker and most vulnerable to external pathogens, of which cold and heat, damp heat and toxins are the main ones.
(1) Injured by cold and dampness: the diarrhea is clear and watery.
(2) Invasion of damp poison: the diarrhea comes with abdominal pain, urgent diarrhea, such as water injection, or yellowish brown and smelly feces.
Correspondingly, Huoxiang Zhengqi San or Gegen Qinlian Decoction were given to patients of coldness or heat.
Personal experience: In most cases, diarrhea produced during tumor treatment is caused by intestinal mucosal damage and a consequent significant decrease in absorption function. Tumors are fast-proliferating cells, and most treatments are aimed at suppressing cancer cells with feature. Unfortunately, intestinal mucosal cells also proliferate quickly. Because it is often difficult to target 100% of cancer cells during tumor treatment, intestinal mucosal cells have become the victims of this off-target effect. Our treatment should focus on repairing this kind of damage. Therefore, I focus on strengthening the spleen and replenishing qi, and use the main prescription as Shenlingbaizhu San. Then, use high dose of herbs that have the function of tonifying Qi, such as ginseng, astragalus, etc. It can often achieve the effect of stopping diarrhea, strengthening the body and without obvious side effects.