Question

Pamela Allen is a 65-year-old woman who has been married to Clifford for 40 years. Their only child, Gary, has Down syndrome and lives with them. Mrs. Allen stopped working outside the home after Gary was born to care for him. She has recently been diagnosed with advanced colorectal cancer and had surgery last month (colectomy and colostomy). Because the tumor extended into the perineum and lymph nodes, she has been advised to start radiation and chemotherapy. She underwent treatment for endometrial cancer at age 50 but did not receive chemotherapy or radiation at that time.

As a result of chemotherapy and radiation causing bowel irritation, Mrs. Allen develops severe acute diarrhea. What changes would you recommend to Mrs. Allen's fluid intake to maintain adequate fluid balance and normal electrolyte levels?

Answer 1

• Patient should be advised not to take foods that aggregate diarrhoea
• Aggressive oral rehydration therapy should be given
• Fluids with salt , water, sugar should be given.
• Monitoring should be done to prevent the severe dehydration and it's complications like hypovolemic shock and come and even death.
• Budisonide is known to produce some benefit from this chemotherapy induced diarrhoea.
• Long acting drugs like octreotide can be given.
• Probiotics should be given to replenish the intestinal flora as diarrhoea might have washed out many important diarrhoea.