Tips for managing eating problems

Cancer and cancer treatments can sometimes cause eating problems. Below are tips to help you manage your diet if you have eating problems. We also have more information on mouth problems that can be caused by cancer treatment.

Constipation means that you are not able to empty your bowels (poo) as regularly as you usually do. It can become difficult or painful for you to empty your bowels. Cancer treatments and medicines such as painkillers and anti-sickness drugs can cause constipation.

Here are some tips that can help with constipation:

• Eat plenty of fibre each day. Good sources of fibre include: wholewheat breakfast cereals (Weetabix^®, Shredded Wheat^® or muesli), wholemeal bread, flour and pasta, brown rice and fresh fruit and vegetables.
• Drink plenty of fluids – both hot and cold drinks will help. Aim to drink at least 2 litres (3½ pints) a day. This is very important if you increase the amount of fibre in your diet. Eating fibre without drinking enough fluids can make constipation worse.
• You could try a natural remedy for constipation. This includes prune juice, prunes, fig syrup and dried apricots.
• Gentle exercise, such as walking, will help keep your bowels moving.
• If you are constipated because of the medicines you are taking, it may be possible to change the dose you take. Talk to your doctor about this.
• You may need to take laxatives (medicines that help you empty your bowels). Your doctor can give you more advice.
• If you have cancer of the bowel, or you think your cancer treatment is causing constipation, ask your doctor or specialist nurse for advice.

The amount of wind we produce depends on how healthy bacteria and digestive enzymes in our bowel combine with the foods we eat.

Some cancer treatment and some types of medicine can cause wind. It can also be caused by constipation. We have more information about the causes of wind and tips for managing it.

If passing wind becomes painful, tell your doctor.

You may lose your appetite during cancer treatment. This may be because you feel sick or tired, or because food and drink taste different.

If you have problems with your diet or appetite, ask your doctor at the hospital to refer you to a dietitian. If you are at home, your GP or district nurse can refer you to a community dietitian.

They can review your diet and your dietary requirements. They can advise you on which foods are best for you, and whether any food supplements would be helpful.

These tips might help:

• Instead of having three big meals a day, try eating small, frequent meals or snacks. If you find certain times of the day are better for you to eat, try to eat then.
• Keep snacks handy to eat whenever you can. Nuts, crisps, dried fruit or cheese and crackers are quite light and tasty. If these are hard for you to chew or swallow, try yoghurt, peanut butter or fromage frais instead.
• Try to make your food look as attractive as possible. Put small portions on your plate and add slices of lemon or tomato, or parsley. You could use a small plate to serve food on.
• Drinking a small amount of alcohol just before, or with food, may help to stimulate your appetite. Check with your doctor that you can have alcohol.v
• If you have recently had surgery or radiotherapy for bowel cancer, you may need advice about the best foods for you. Talk to your dietitian, specialist nurse or doctor.
• Have sweet or savoury nourishing drinks as well as small meals. Sip these slowly through the day. The sugar in these drinks can damage your teeth. It is important to wash your mouth out with water after having any sugary drinks and to brush your teeth regularly.
• Eat your meals slowly, chew the food well and relax for a little while after each meal.
• Sometimes the smell of cooking can be enjoyable, but sometimes it can put you off eating. If you have family or friends who would like to help, ask them if they could cook for you. Or try to eat cold foods that do not need cooking, or ready-made foods that can go straight in the oven or the microwave.
• Everyone’s appetite changes and you may have good and bad days. Make the most of the good days by eating well and treating yourself to your favourite foods.
• Try to eat your meals in a room where you feel relaxed and where there are no distractions.
• It may be possible to stimulate your appetite using medicines, such as a low dose of steroids or the hormone medroxyprogesterone. Your doctor may prescribe these for you.

Some medicines, such as steroids, may increase your appetite. If this happens, try to eat healthy foods such as fruit and vegetables instead of sweets and crisps.

We have more information about making healthy food choices.

• Ask the person you are caring for what they would like to eat.
• Try to talk openly about their eating problems or weight loss. Talk about the different ways you could both manage it. This can help you both feel more in control of the situation.
• Try to give them small meals and snacks, whenever they feel like eating. This might be better than eating at set times of the day.
• Offer their favourite foods at the times when you know their appetite is at its best.
• The person you are caring for may find that the smell of cooking makes them feel sick. Prepare food in a different room if possible.
• Keep a range of different foods in the house so that you can offer them something at any time of the day. Tinned foods and pre-prepared frozen meals can be as good for them as a meal that takes a long time to prepare.
• If they cannot manage solid food, try soft foods. This might include porridge, bananas, soup, shepherd’s pie, yoghurt or milk-based foods like custard or rice pudding.
• Make batches of their favourite meal and freeze some for a quick meal at another time.
• Moist food is often easier to eat and will help to prevent a dry mouth, so try adding sauces or gravies.
• You may need to use a liquidiser or blender for some dishes. You may find it helpful to use meal-delivery companies. Supermarket home-delivery services may make shopping easier for you.
• Try using supplements to add energy to everyday meals and drinks. For example, you could try adding fortified milk or cream to tea or coffee. You can also add cream, butter or cheese to meals.
• Take care preparing food if the person you are caring for may be at risk of infections and food poisoning. The doctors or dietitian will be able to advise you about this. We have information about food hygiene and lowered immunity.
• The person you are caring for may have side effects of treatment. These might be nausea, vomiting, taste changes, a sore mouth or changes to bowel habits. A member of their medical team can either prescribe something to help or refer them to a dietitian.

• Try to serve food in a well-ventilated room to help if the person you are caring for has nausea.
• Keep servings small. Offer extra helpings rather than putting too much food on the plate to begin with. Too much food can be overwhelming and off-putting.
• Try not to worry if they cannot always eat what you have cooked. Gently encourage the person you are caring for to eat. But try not to push them too much. It helps to create a relaxed atmosphere at mealtimes.
• If someone’s sense of taste or smell has changed, it can sometimes help to serve food cold or at room temperature.
• Use plastic cutlery if the person affected by cancer notices a metallic taste in their mouth.
• Try to create a comfortable eating environment.
• Serve meals so they look appetising.