10 Secrets to Better Digestion After Colon Cancer

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Getting a diagnosis of colorectal cancer comes with an array of potential treatment options, possible clinical trials, and perhaps surgery. There is absolutely a lot to think about. But as you (or your loved one) navigates through the colorectal-cancer journey, one of your biggest questions might also be one of the most basic: What will I be able to eat?


Roger Smith

One Patient's Perspective

Roger Smith, 72, was definitely concerned about how his body would handle food after he was diagnosed with colon cancer last year. Smith, a Minneapolis construction worker, had seen his father and brother go through colon-cancer treatment, and they weren’t given any insight into digestion changes and positive strategies that they could employ after treatment.

“I didn’t want that to happen to me,” he says. “So, I tried to be smart and follow my nutritionist’s advice. And I felt charged up to make good changes that helped my digestive system heal.”

Here are some tactics Smith used, and that anyone who’s been through colorectal cancer can consider.


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Say Cheers With a Zero-proof Drink

One of the first items to go for Smith was his nightly beer or two, since it made him feel bloated and uncomfortable. That’s not surprising, according to Mark Pochapin, M.D., a gastroenterologist at NYU Langone Medical Center, New York. He says that alcohol can cause irritation to the stomach and intestine. Research has also suggested that excessive alcohol consumption may increase risk of additional polyp development, especially for those with tumors.

But this doesn't mean you can't indulge: Sip smarter and go for a mocktail instead.


Stay Hydrated

The simplest guideline for how much water you should drink is to aim for half your body weight in ounces. So, if you’re 200 pounds, drink 100 ounces of water daily. Colorectal- cancer patients should focus on appropriate water intake for a number of reasons, Dr. Pochapin says.

For example, many medications and even certain types of chemo may cause some people to lose water more rapidly, putting them at risk for dehydration, he notes. Also, water will help “flush out” your system, which is beneficial to all your organs.


Get Super Focused on Self-Care

Adopting certain lifestyle changes can help you manage some of the gastrointestinal changes that colon cancer can bring, says Filomena Trindade, M.D., of the Institute for Functional Medicine in Federal Way, WA.

For instance, it can help quite a bit to get enough sleep, focus on de-stressing, stay active, and schedule time for socializing. All of these self-care strategies have been shown to have positive effects on the digestive system, Dr. Trindade says.


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Be Proactive About Handling Constipation

Constipation, in particular, is a very common problem for colorectal-cancer patients. The biggest culprits tend to be chemotherapy, opioids and other pain medications, drugs for anxiety and depression, sleep medication, anesthesia during surgery, diuretics, antacids, and supplements like calcium and iron. Talk with your doc before taking over-the-counter meds like a laxative or stool softener, says Dr. Pochapin, to make sure they won’t conflict with something you’re already taking. Chances are, your doc can adjust your meds mix to get you back on track.


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Aim to Eat Cleaner

Your specific eating plan should be discussed with your care team’s nutrition expert, but in general, foods that are high in fat or sugar can be problematic when you’re dealing with colorectal cancer, says Dr. Pochapin, especially if they’re taking the place of healthier options. Like we all know, they're simply not the best choice nutritionally.

Instead of greasy or sugary foods, try to eat a variety of fruits and vegetables, lean protein, and healthy fats like olive oil and avocados.


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Experiment with Fiber

High-fiber foods are excellent for delivering nutrients to your system and helping your digestive system get back on track. But it may take you time after colorectal-cancer treatment to digest these foods properly. This can happen if you have a colostomy or ileostomy as well. For instance, you may find that food like onions, cabbage, beans, and apples make you feel gassy and bloated, to the point of stomach cramps.

The usual advice, says Dr. Pochapin, is to start on a low-fiber diet after a treatment like colorectal-cancer surgery, and then gradually increase the amount of fiber over a number of weeks. As you do so, you may notice that certain foods are a no-go while others become increasingly tolerated. You could also do well with a number of small, frequent meals throughout the day instead of three larger meals.


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Focus on Staying at a Healthy Weight

According to the American Cancer Society, being overweight or obese can raise your risk of colorectal cancer returning if you’re in remission. There are other benefits as well to making sure your weight stays on track, including better sleep, more energy, and a stronger immune system.

“Weight can certainly fluctuate up and down during treatment,” said Dr. Pochapin. “But talk with your doctor about what your goal weight should be based on your age, activity level, height, and other factors. Then, as weight begins to stabilize, you’ll have a good general idea of where you need to be.”


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Stay Connected to Your Dietician

Your diet can change dramatically throughout the course of colorectal-cancer treatment. Smith had to cut back on salt because it irritated his digestive system and caused bloating, especially after chemo. But a few months after chemo was complete, he began adding small amounts back in and found he had no issues.

“My main message would be to keep in touch with your nutritionist or dietician, and have a list of questions ready for your next call,” he says. “Your nutrition professional is there to help you, so use that resource.”


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Keep a Log of Symptoms

You tend to feel pain within a few minutes of eating, or you have alternating bouts of diarrhea and constipation, or you may have struggles with a colostomy pouch. Even if you’re experiencing mild discomfort, it’s worth jotting down because it may indicate an easily fixable issue before it becomes a problem, according to gastroenterologist Anton Bilchik, M.D., at John Wayne Cancer Institute, Santa Monica, California.

“Keeping a simple log book of times and dates of symptoms or challenges can help us begin to see patterns that may be a concern,” he says. For example, you may not think you’ve been constipated for long, but see from your logbook that it’s been over a week since you’ve had a bowel movement. That’s the kind of info that’s crucial for your care team to know.


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Be Patient as You Adapt

The hardest thing for Smith to do was to be flexible and adapt to changes. He jokes that his background as a crane operator might have worked against him.

“In my career, you build a structure and you’re done,” he says. “There are no constant re-adjustments if something isn’t working, no re-building a room to see if that works better. So, having colon cancer was a big lesson in patience for me.”

He learned to be more mindful and integrate some good mind-body strategies like deep breathing and meditation, which he says helped to calm his nervous stomach just before chemo treatments. “You have to acknowledge that the way you ate before, and the way your whole digestive system worked before, might not be the same during treatment, and honestly, may never be exactly the same again,” he says. “Just breathe through it, readjust, and focus on today.”