Abdominal radiotherapy: Reducing wind and bloating during your treatment

This leaflet explains about dietary advice when you are receiving radiotherapy to the liver or pancreas. If you have any further questions, please speak to your doctor, radiographer or dietitian caring for you. 

It is normal to produce wind or gas (flatulence) as part of the digestion process.

Excessive gas can affect the shape of your bowels and move the position of the bowels and other organs close to the bowel. If you are having radiotherapy to your abdominal area, this can affect your treatment.

The radiographers take daily images and are able to assess the treatment area prior to treatment. However, steps to minimise gas will be helpful for your treatment to progress with minimum disruption. 

This information gives you some suggestions on how you may be able to reduce gas in your bowel through diet and lifestyle changes.

You may need to introduce small changes into your diet or lifestyle for the duration of radiotherapy treatment.

Sometimes, the changes suggested below may not have any impact on reducing the gas in your bowel. If this is the case, please do not worry. It is important to remember the changes below are only temporary changes and once treatment is complete you can return to your usual diet.

Lifestyle changes

• Chew your food more slowly and thoroughly. 
• Avoid talking when eating.
• Avoid chewing gum.

These changes will minimise you swallowing more air and will decrease wind and bloating.

Try to increase your activity, if you feel like you can, as this will encourage bowel movements and air will pass through your digestive system as a result. Even a little walk around the garden or house can help.

Changes to your drinking 

While on radiotherapy, try to drink 8 cups or 2 litres of fluid a day. Water is best but you do not need to remove other alternatives. 

• Allow hot drinks to cool down.
• Sip your drinks slowly.
• Try not to drink large amounts with meals.
• Avoid straws and gulping your drinks.
• Avoid fizzy (carbonated) drinks e.g. cola, lemonade, sparkling water and sparkling alcoholic beverages. Or, if you like the taste of these, leave them go ‘flat’ before drinking.
• Reduce caffeinated drinks e.g. tea, coffee, cola, energy drinks. Try decaffeinated options instead. Keep caffeinated drinks to a maximum of 2 mugs per day.
• Try herbal tea e.g. peppermint tea.

Food

Avoid skipping any meals and ensure you have regular meals, spaced out throughout the day.  

Avoid foods that you know make you more gassy. Try and limit foods that are known to increase wind and bloating, such as:

• Beans and pulses
• Vegetables such as cabbage, brussels sprouts, broccoli, cauliflower, onions, leeks, mushrooms, peas and sweetcorn
• Dried or excessive fruits (no more than 5 portions a day)
• Artificial sweeteners
• Avoid sugar-free sweets or chewing gum
• Fatty foods like chips, fast foods, pies, batter, cheese, pizza, crisps, chocolate, cakes and biscuits, butter, cooking oils burgers or sausages

Try and reduce your intake of processed foods and cook from fresh ingredients where possible. Some herbs and spices such as peppermint and ginger may help you digest your food and reduce wind.

The introduction of oats into your diet may also help - for example, oat-based cereal or porridge oats. 

Probiotics 

Probiotic supplements, yoghurts or drinks (e.g. Actimel™, Yakult™) may reduce your symptoms of wind and bloating. If you decide to take these, it is recommended they are taken daily for at least four weeks to see whether they improve your symptoms.

If you are on chemotherapy, you may be advised to avoid probiotics and probiotic drinks due to infection risk. Please check with your oncologist or dietitian before starting these.

Fasting

If you are required to fast before your radiotherapy, it will usually be for 2 hours. Try to eat something small and light before you fast. Avoid fasting for more than 4 hours as this can then cause gas to build up. 

Medication

You may be prescribed certain medications, such as Lansoprazole or Omeprazole, by your doctor or oncologist. You might also be advised to take some over-the-counter medication such as Wind-eze, WindSetlers or wind relief which can sometimes help with wind, bloating, indigestion and reflux. 

If you are prescribed pancreatic enzyme replacement therapy (Creon10,000, Creon25,0000, Nutrizym22) with your food:

Excess wind and bloating can be a sign that you are not digesting and absorbing your food well. If this is the case, you may need to increase your pancreatic enzyme replacement therapy doses with your meals, snacks and milky drinks, including, oral nutritional supplements.

If you need further advice, please speak with your Hepato-Pancreato-Biliary (HPB) oncology dietitian or a member of the HPB oncology team that you are under. 

This information has been reviewed by Cheshire and Merseyside Cancer Voices to check it is easy to understand. Cheshire and Merseyside Cancer Voices is a panel of cancer patients who volunteer to read NHS information to make sure it makes sense to people. They have been brought together by Cheshire and Merseyside Cancer Alliance.