Care tips

•Provide food that the patient likes

•No big portions, but small, more frequent meals

•Some exercise before meals, for example, going for a walk in fresh air

•Avoid food that is filling or causes flatulence (e.g., cabbage, broccoli, fresh mushrooms, salads, raw fruit, e.g., prunes, plums)

•Complementing and enriching meals: a number of specialized products are available through nutritionists

•Fruit milk shake (high in protein and energy)

•Energy drinks and complementary nutrition can be specifically discussed with the nutritionist

•Eating should not be an imposition

•Drinking between, rather than during meals, as fluids fill the stomach and easily lead to early satiety

•No sweet drinks; drink at least 30 min before eating

•Where food intake is painful, consult the doctor

•Appearance of food has a huge effect on appetite

•Loss of appetite under chemotherapy usually disappears after completion of therapy, which is something the patient must know

Eating habits are very individual and quality of nutrition is therefore variable. The nutritionist or nurse should be consulted for advice.

19.2.6Digestive Disorders (Constipation and Diarrhea)

Digestive disorders such as constipation and diarrhea curtail well-being. An optimal treatment is possible only when the underlying cause is identified.

19.2.6.1Constipation

Constipation is the absence of bowel movements over several days or when action of the bowels is perceived as abnormal (e.g., feeling of illness, loss of appetite, abdominal pain, painful straining to defecate, hard and dry stools).

Causes

•Drugs: For example, chemotherapeutic agents: vincristine; iron preparations, opiates, spasmolytic agents, antidepressants

•Metabolic disorders such as deficient activity of the thyroid gland (hypothyroidism)

•Pain

•Prolonged bed-ridden state, lack of activity

•Dehydration, roughage-deficient nutrition

•Psychological influences such as depression, anxiety

•Neurological disorders such as spinal and cranial nerve lesions