Powered By
Issues like diarrhea, cramping, and constipation can complicate life with multiple myeloma. Both the disease itself and the therapies used to treat it may promote these problems.
“I deal with severe constipation all the time,” one MyMyelomaTeam member wrote. Another said, “I’m very fatigued and have diarrhea.”
Read on to learn about bowel problems in multiple myeloma.
Sign up to view the results!
Continue with Facebook
Continue with Email
Understanding what can cause digestive issues with myeloma can help you and your providers get to the root of the problem.
Multiple myeloma may lead to high calcium levels in the blood. Known as hypercalcemia, this can cause constipation and an upset stomach.
High calcium forces the kidneys to work harder to flush the mineral out of your system, which often requires more water. As a result, your bowels have less water available, which can lead to hard stools and constipation.
Amyloidosis happens when proteins build up in your organs. Some people develop amyloidosis with multiple myeloma. Amyloidosis symptoms may include diarrhea, constipation, nausea, and other digestive problems.
Bowel problems like constipation, diarrhea, and nausea can also be common side effects of multiple myeloma treatment.
Many drugs used to manage cancer-related symptoms like pain, swelling, and inflammation can also cause constipation. Examples include corticosteroids, morphine, and opioids.
The targeted therapy bortezomib (Velcade or Boruzu) also lists constipation as a possible side effect. In addition, medications that promote dehydration could also cause constipation.
Myeloma can lead to kidney damage that may progress to kidney failure. Dialysis is necessary if the kidneys fail. For some people, dialysis is associated with constipation.
A cancer diagnosis can have a strong effect on your emotional well-being. Studies show that up to 40 percent of people with cancer have undiagnosed psychological effects like depression and anxiety.
Since the gut and brain are closely linked, bowel symptoms may be related to mental health and the stress of cancer.
Being diagnosed with multiple myeloma or dealing with cancer treatment can change your eating, drinking, and exercise habits. These changes, such as eating differently, being less active, and not drinking enough fluids, can all lead to constipation.
Diarrhea is one of the most common and difficult symptoms to manage with myeloma. Diarrhea can be so severe that it may cause changes or delays in treatment.
Diarrhea can be caused by amyloidosis, which sometimes occurs with multiple myeloma. Some other amyloidosis symptoms include abdominal pain, weight loss, and bleeding.
Diarrhea is a possible side effect of the drug lenalidomide (Revlimid). Research suggests that Revlimid may cause bile acid malabsorption, meaning that your small intestines can’t absorb bile salts properly. The extra salts cause your colon to release more water, which leads to watery stools.
Revlimid may cause late-onset diarrhea that begins 17 to 24 months after starting treatment.
If you’re concerned about diarrhea from myeloma or your cancer treatment, your doctor can offer suggestions on managing diarrhea and other gastrointestinal (GI) symptoms or side effects.
Always talk to your oncologist before taking any medications to manage symptoms or side effects, including over-the-counter (OTC) medications. Also ask your doctor before changing your diet to avoid negative interactions with your treatment.
You may be able to manage diarrhea with the following strategies.
If diarrhea is severe, your doctor might lower your dose of chemotherapy or stop the drug causing the issue.
Bile acid sequestrants are medications that help lower cholesterol. These medications work by binding to extra bile acid. If diarrhea is due to bile acid malabsorption, bile acid sequestrants may reduce watery diarrhea caused by poor bile absorption.
However, bile acid sequestrants may interact with other medicines. You should only use them under your doctor’s supervision.
Mindful diet and nutrition changes may help improve diarrhea for those with multiple myeloma.
You may need more fluids and salts to replace what your body loses when you have diarrhea. But if you have kidney issues, talk to your doctor before changing your diet.
Here are some foods that may help with diarrhea:
Here are some foods that you may need to avoid to help manage diarrhea:
Additionally, many people with multiple myeloma can develop secondary transient lactose intolerance during therapy. While plain Greek yogurt is often tolerated, other milk and soft cheese products can worsen symptoms and may need to be avoided.
Some MyMyelomaTeam members keep a food diary to track which foods affect their GI symptoms. One member shared, “I’ve been having diarrhea these last few days. A month ago I was fine. I had a colonoscopy — all was good. I decided to keep a diary of my food.”
Diarrhea causes your body to lose fluids, which can lead to dehydration. If you have diarrhea, try to drink at least 8 to 12 cups of room-temperature water or other hydrating drinks every day.
After a bout of diarrhea, drinking clear liquids like water and broth can help replace lost fluids and give your bowels time to rest. If you have heart failure or kidney problems, ask your doctor if you need to restrict how much fluid you drink at once.
Both OTC and prescription medications may help manage diarrhea related to multiple myeloma or chemotherapy. Only take medications as directed by your doctor.
Talk to your doctor before making any changes to your diet, medication, or lifestyle. You can ask them about these tips to help with constipation.
Stay Hydrated
Dehydration can cause constipation or make it worse. If you’re struggling with constipation, try drinking prune juice.
“I had an awful problem with constipation for the longest time,” one member said. “This worked for me: A small glass of warm prune juice in the morning, followed by two prunes at a time, three times a day with a glass of water.”
Constipation and bowel obstruction (blockage) make it harder for you to pass stool and may lead to bloating. Eating foods rich in fiber may help prevent and relieve constipation. However, fiber does not prevent bowel obstruction. In fact, fiber can make an obstruction worse.
If you have severe abdominal pain, vomiting, major bloating, or can’t pass stool or gas, seek urgent medical care. Don’t up your fiber intake until you’re sure there’s no obstruction.
There are two main types of fiber: soluble and insoluble. Both types may help ease constipation.
Examples of high-fiber foods you may want to include in your diet are:
Increase your fiber intake gradually, and pair it with enough fluid to support digestion.
When done correctly, some exercises can help speed up your bowel movements. Always talk to your doctor or physical therapist before trying new exercises. They will help you choose movements that are safe for your bones, spine, blood counts, and current energy levels.
If your care team confirms it is safe for your back and hips, one helpful exercise to stimulate your bowels is bicycle pedals.
To do this exercise, lie on your back and raise your knees to a 90-degree angle. Then, “pedal” your legs in the air as if riding a bike. Try to do this for at least 15 seconds at a time, repeating five times. If you feel too weak, go slow, or ask a caregiver or loved one to help you.
Try Compresses and Massage
Some people say that natural remedies like applying heat, cold, or gentle massage can help with the discomfort of being constipated. But they may not be a safe approach if you’ve had recent surgery or have a blockage. See your doctor first if you have severe bloating, pain, fever, or other signs of an infection or obstruction.
Abdominal pain is a common symptom of hypercalcemia, which is linked to multiple myeloma. Painful stomach cramps and bloating can also happen due to bile acid malabsorption.
More than 170 MyMyelomaTeam members have experienced abdominal pain and bloating from myeloma complications and treatments. One member talked about bloating from corticosteroids, which can be used alone or with other drugs to treat multiple myeloma. They said, “The only drug that gives me grief is the steroids with bloating, gas, and constipation.”
Abdominal pain may happen on its own or with other GI symptoms, like constipation, weight loss, or nausea with multiple myeloma. Another MyMyelomaTeam member shared, “I had a bad reaction to Revlimid. Abdominal bloating, gas pains, and nausea. Doc took me off all meds for one week to let my system stabilize.”
If you’re dealing with abdominal bloating or pain, it’s important to talk to your doctor, especially if it affects your quality of life. They can suggest treatments to help manage your symptoms.
Never stop or adjust medications on your own. Always consult your healthcare provider before making any changes. The support of your healthcare team can help get your digestive system on track to improve your quality of life.
Get updates directly to your inbox.
My bones are starting to feel weak ,will I loose my ability to walk over time especially since I have lost so much weight?
Continue with Facebook
Continue with Email
Continue with Facebook
Continue with Email
Become a member to get even more
Join
Your Privacy Choices
This is a member-feature!
Sign up for free to view article comments.
I pray for you all, remission is a good place to be, I am a Stage 3 and going up and down, all over the place. Thank you for the comments. Elizabeth🥰
We'd love to hear from you! Please share your name and email to post and read comments.
You'll also get the latest articles directly to your inbox.