Side Effect: Stomach Cramps

What are stomach cramps?

Stomach cramps are characterized by a painful, tight feeling in the muscles of the belly. They are a common symptom caused by a variety of factors including gastrointestinal infections, food intolerances, menstrual cramps, and inflammatory bowel disease. Less commonly, stomach cramps may also be a symptom of cancer.

What do stomach cramps look like?

The sensation of stomach cramps can vary depending on the patient. Generally, they feel like a sharp, intense pain or a dull, persistent ache in the abdominal area. Some may also experience symptoms like nausea, vomiting, diarrhea or constipation, and bloating along with their stomach cramps.

Who gets stomach cramps?

Patients with cancer can experience stomach cramps because of their disease or cancer treatment, including medications and radiation. Cancer itself can cause abdominal pain if it spreads to other parts of the body, like the liver or pancreas. Chemotherapy medications can cause gastrointestinal side effects, including stomach cramps.

How do you prevent stomach cramps?

There are multiple ways to help prevent stomach cramps in patients with cancer. Healthcare providers may use multiple approaches to target different aspects including the foods to avoid and medications to take before chemotherapy to prevent nausea, vomiting, and ultimately cramping. Common recommendations are below to prevent stomach cramping in patients with cancer:

• Staying hydrated: water or electrolyte-containing drinks (ex: Gatorade)
• Foods to incorporate: high-fiber diet (ex: avocado, broccoli, raspberry, beans, chia seeds)
• Foods to avoid:
  
  • Hot, spicy foods
  • Greasy foods
  • Large meals
• Anti-nausea medications:
  
  • Ondansetron (Zofran®)
  • Prochlorperazine (Compazine®)
  • Metoclopramide (Reglan®)
  • Olanzapine (Zyprexa®)
  • Aprepitant (Emend®)
  • Dexamethasone (Decadron®)
  • Scopolamine (Transderm Scop®)

How to treat Stomach Cramps

As mentioned for prevention, treatment of stomach cramps may include dietary changes and medications that prevent nausea and vomiting. Additionally, healthcare providers may prescribe a category of medications called antispasmodics to assist in helping the gastrointestinal (or stomach) muscles relax. Different therapy modalities including acupuncture and massage therapy have helped patients with cancer as well. Some examples of each treatment type are listed below:

• Antinausea medications:
  
  • Ondansetron (Zofran®)
  • Prochlorperazine (Compazine®)
  • Metoclopramide (Reglan®)
  • Olanzapine (Zyprexa®)
  • Aprepitant (Emend®)
  • Dexamethasone (Decadron®)
  • Scopolamine (Transderm Scop®)
• Dietary modifications
  
  • Foods to incorporate: high-fiber diet (ex: avocado, broccoli, raspberry, beans, chia seeds)
  • Foods to avoid: hot, spicy foods, greasy foods. large meals
• Antispasmodic medications:
  
  • Anti-cholinergic medications: dicyclomine (Bentyl®), atropine (AtroPen®), hyoscyamine (HyoMax®), scopolamine (Transderm Scop®)
  • Calcium channel blockers: amlodipine (Norvasc®), verapamil (Calan®), diltiazem (Adizem®)
  • Smooth muscle relaxants: cyclobenzaprine (Flexeril®), baclofen (Lioresal®), methocarbamol (Robaxin®)
• Pain medications:
  
  • Hyoscine butylbromide
  • Acetaminophen (Tylenol®)
  • Opioids: hydrocodone (Vicodin®), oxycodone (Roxicodone®, Percocet®), morphine (MSIR®)
• Acupuncture
• Massage therapy

Overall, stomach cramps treatment depends on the underlying cause (nausea, vomiting, pain, etc.). After the cause is identified, treatment choice will aim to target this cause and hopefully provide relief for the patient.