The following information is available in more depth from pages 14-19 of your About Carcinoid Nutrition Guide provided by TerSera.
In this article you will learn more about the different types and causes of diarrhea that can accompany some types of GI NETs. Having a better understanding of the type(s) you’re experiencing can help you have more informed conversations with your healthcare provider about making healthy changes.
Diarrhea Type/Cause: Steatorrhea
This type of diarrhea can happen when your pancreas is not producing the enzymes needed to properly digest food and break down fats. It can be caused by several factors, including some surgeries and side effects from somatostatin analog therapy (SAA). You are more likely to experience steatorrhea after receiving an SSA injection.
If you think it might be steatorrhea, you should keep an eye out for:
• foul smell
• floating stools
• gas and abdominal pain
• leaves a ring around the toilet, and may have a pale colour.
To address this type of diarrhea:
• you can stick to low-fat foods
• avoid foods like fried chicken and bacon that are high in fat
• ask your healthcare provider about pancreatic enzymes
Diarrhea Type/Cause: Secretory
Those with Carcinoid Syndrome may experience secretory diarrhea. When GI NETs spread, they can release several peptides and hormones, including serotonin. Overproduction of serotonin in the gut contributes to the symptoms associated with Carcinoid Syndrome. Somatostatin analog therapies may help reduce the amount of serotonin that the GI NETs produce and may help with symptoms. But over time, the SSAs can lose their effectiveness.
If you think it might be secretory diarrhea, you should keep an eye out for:
• watery stools
• waking up in the middle of the night for a bowel movement, even if you didn’t eat anything before you went to sleep
To address this type of diarrhea:
• you can eat small, frequent meals
• eat plenty of protein
• eat foods that are low in amines
• stay hydrated
Diarrhea Type/Cause: Rapid Transit Time
Rapid transit time diarrhea may be experienced by those who have had a small bowel resection. “Rapid transit time” refers to when food moves through your body at a faster-than-average speed.
If you think it might be rapid transit time diarrhea, you should keep an eye out for:
• having a bowel movement almost immediately after eating (in as little as 30 minutes)
• experiencing weakness, hunger, or a faster heart rate 2 to 3 hours after eating
To address this type of diarrhea:
• eat small, frequent meals (up to 5 to 6 per day)
• separate solids and liquids at meals (eat solid foods first)
• choose soluble fibre over insoluble fibre
• chew foods well
• limit fluids with meals
• avoid concentrated sweets
Diarrhea Type/Cause: Bile Acid
When a large amount of bile acid gets into the colon, it can result in bile acid diarrhea. This often happens in those who have had surgeries of the upper intestinal tract, including gallbladder removals.
If you think it might be bile acid diarrhea, you should keep an eye out for:
• burning diarrhea
• urgent and frequent trips to the bathroom
• yellow in color
To address this type of diarrhea:
• avoid greasy, high-fat foods
• ask your healthcare provider about taking multivitamins, probiotics, and oral bile acid sequestrants
Want to know more?
To get to know the kind of diarrhea you may be experiencing most often, remember to track your bowel movements in your Stool Tracker. Your CNE is also available to help you with any questions or concerns you might have about your symptoms. For more information on ‘Get To Know Your Symptoms’, go to your About Carcinoid Nutrition Guide provided by TerSera.