ABSTRACT
Diarrhea occurs in up to 10% of cancer patients, but up to 38% in acquired immune deficiency syndrome (AIDS). It is distressing for both patients and carers and causes dehydration, electrolyte disturbances and loss of comfort and dignity. A wide range of drugs can cause diarrhea and the drugs usually need to be stopped. Previous surgery can cause diarrhea through a number of mechanisms. Gastrectomy patients can sufer from food being 'dumped' into the bowel, causing nausea, bloating and diarrhea. Loperamide increases water absorption by slowing forward peristalsis. Caution is necessary with infective diarrhea since slowing peristalsis can cause overgrowth of dangerous pathogens and increased absorption of bacterial toxins. Octreotide has been used in AIDS-related diarrhea, cancer, in postgastrectomy dumping, and may also have a role to play in other causes of severe refractory diarrhea, although more evidence of eicacy is needed.
