Bladder and bowel problems

Bladder problems might include:

• needing to pass urine (pee) more often than usual (frequency)
• being unable to wait to empty your bladder (urgency)
• leaking urine (incontinence)
• a burning feeling or pain when you pass urine (cystitis)
• blood in your urine (haematuria)
• difficulty passing urine, or a feeling you still have urine left in your bladder after going to the toilet (retention)
• pain in the pelvic area.

Contact the hospital straight away if:

• your symptoms get worse
• you have a high temperature or fever
• you feel you cannot pass urine.

Tell your cancer team if you have a burning feeling or pain when you pass urine, or if your urine is cloudy or smells strongly. You may be asked to give a urine sample to check if you have an infection. An infection is a common cause of symptoms and is easy to treat.

If bladder problems do not improve with treatments, your cancer team may arrange tests. Or they may get more advice from a continence specialist.

It can be difficult to talk about bladder problems. But if you tell your cancer team they can help and support you and suggest treatments to help.

There are some things you can do that may help with bladder and bowel problems:

• Try to drink at least 2 to 3 litres (3½ to 5½ pints) of fluids a day, unless your cancer team tell you something different.
• Avoid drinks such as tea, coffee, cola and alcohol. These can irritate your bladder and make symptoms worse.
• Try to drink fewer acidic drinks (orange or grapefruit juice) and drinks with artificial sweeteners (diet or ‘light’ drinks).
• Drink cranberry juice to help reduce bladder symptoms – but not if you take warfarin (a drug to thin the blood). You can also get cranberry capsules from your pharmacy.
• If you smoke, try to stop. Smoking can make bladder and bowel side effects worse.
• Use exercises to strengthen the muscles used for bladder and bowel control (pelvic floor exercises).
• Look at our tips for finding a toilet when you are out in public.

You can get more information about products and services from Bladder and Bowel UK and the Bladder and Bowel Community.

If bladder and bowel side effects do not get better, tell your cancer team.

It may help to find out where public toilets are before you go out. The Great British Toilet map can help you to find public toilets by postcode or through the location on your mobile phone. There are also toilet apps for mobile phones.

Macmillan has a free toilet card you can use. It may help you access a toilet more quickly when you are out. You can use it in places such as shops and pubs. The card says you have a medical condition that means you need urgent access to a toilet.

You can also use disabled toilets. These often have more privacy. They have a wash basin and more space if you need to change. The National Key Scheme for Toilets offers access to about 9,000 locked public toilets across the UK. You can buy a key online from places such as Disability Rights UK. They also have a guide that explains where the toilets are.

If you are worried about going out, we have more information about bladder and bowel changes and accessing public toilets.

Diarrhoea means passing more stools (poo) than you normally do, or having watery or loose stools. If you have a stoma, it will be more active than usual.

Causes of diarrhoea

Cancer drug treatments

Some chemotherapy drugs and targeted therapy drugs can cause diarrhoea. Immunotherapy can cause the immune system to become too active. This can also cause bowel problems.

Radiotherapy to the pelvic area (lower tummy) can cause diarrhoea. This is usually during treatment, but it can happen months or years later. We have more information about pelvic radiotherapy and the late effects.

If your diarrhoea is caused by radiotherapy, chemotherapy or targeted therapy, it is important to take the anti-diarrhoea medicines prescribed by your cancer team. If you have diarrhoea after surgery for bowel cancer, talk to your doctor or specialist nurse before changing your diet.

Other medications

Diarrhoea can be caused by an infection or antibiotics. Antibiotics can destroy the healthy bacteria normally found in the bowel. Eating live yoghurt or drinking yoghurt drinks may help ease diarrhoea caused by antibiotics. This is because the bacteria in live yoghurt can replace the bacteria killed by antibiotics.

But you should avoid live yoghurt while you are having chemotherapy or if your immunity is low.

Diarrhoea may be a temporary, mild problem. But for some people, it can be severe and cause dehydration. They can become very unwell and need to see a doctor or go to the hospital for treatment. It is important to tell your cancer team, or contact the hospital on the telephone number you have been given, if:

• you have diarrhoea
• your diarrhoea is getting worse
• the anti-diarrhoea treatment is not helping.

It is very important to follow any advice you have been given by your cancer team.

Tips for coping with diarrhoea

• Drink at least 2 litres (3½ pints) a day to replace the fluid lost with the diarrhoea.
• Avoid alcohol and coffee. Also avoid fizzy drinks, which can cause wind and stomach cramps.
• Cut down on fibre from cereals, fruit and vegetables.
• Avoid most milk and dairy products, until the diarrhoea has stopped.
• Avoid spicy or high-fat foods.
• Eat small, frequent meals of light food – such as white fish, chicken, eggs, white bread, pasta and rice.

It is always best to check advice with your healthcare team. They can also give you advice that is suitable for you. You may have different needs relating to your cancer type or cancer treatment.