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Managing Common Side Effects of Antiretroviral Therapy

The Brown Blues

 Side effects of antiretroviral (anti-HIV) medications can fall into two general categories: more serious long-term side effects (like changes in the way your body processes fats and sugars) which must be medically managed and short-term side effects (like nausea, diarrhea, bad taste) which cause discomfort but may improve or resolve on their own. With this last group of side effects, the key is to try suggested ways to manage them until the unpleasant side effects do improve or if they do not improve, to find ways of living with them.  This may include, taking prescription medication for the side effect from your doctor. 

A discussion of possible long-term side effects that need medical management or might automatically require stopping a particular medication is better left to your medical provider and pharmacist.  If no healthcare professional has discussed the risks of your particular medications with you, please ask them to.  PCAF can supply you with information sheets about your meds through your case manager or Linda.  However, a handout is not a substitute for discussion with your provider.  If you would like practice in asking for what you need from your provider, your case manager or Linda can do some behavioral training with you on that.  There's nothing strange about needing to practice asking for what you need, so please let us know if you need help with this.

Now to the nitty gritty. Of the "short-term" side effects of anti-HIV medications,  diarrhea is one of the most common and distressing.  But it is also one of the most manageable.  Sometimes it will resolve within the six-week "adjustment period" following the start of a new medication, as will other adjustment effects of starting a new medication, like headache.  And sometimes it will not resolve. Or it may go away and come back at certain times.  It is very important to try to manage it right off the bat before it  causes you to become discouraged with your anti-HIV treatment or to start skipping doses and so jeopardize your health and treatment options (please see handouts in reception area explaining the importance of medication adherence).

The three essential points for managing diarrhea are:

1. Observe and  record the consistency (formed or watery), approximate amount, and frequency (how often in one day) of your stools.  Note when problems first began and what seems to help, if anything.  Communicate this information to your healthcare provider.  These details will help them identify the problem ( Is it medication-related?  Do you have an intestinal or other infection?  Has your system become unable to digest milk products?).  They will then be able to instruct you in  the most appropriate remedies.
   

2. Replace lost fluids.  This means drink water and Gatorade or similar products.  Avoid caffeinated beverages and alcohol.  They can irritate your digestive tract and make you go more frequently.  Avoid milk products unless you are certain that you can digest them.
   

3. Care for the skin around the anal area.  How to do this: Wash with clear, lukewarm water (you can use a soda bottle filled with water).  Pat dry with a very soft cloth - an old cloth diaper is best - that has not been washed in harsh detergents.  Apply a layer of Vaseline or A&D ointment.  If the skin is broken or bleeding, make sure you consult your healthcare provider.

A diet of bananas, rice, applesauce, and toast is a temporary measure for dealing with watery stool.  And white rice is the great healer of the intestines.  The best way to get its benefits is to eat Congee.  To make it, take a cup of white rice and six cups of water. Cook  this slowly, ideally for several hours but at least for thirty minutes.  Congee can be eaten or drunk.  It can be seasoned in a variety of ways.  It is good!  We can give you a handout with ideas on seasoning congee and with other suggestions and recipes for handling diarrhea nutritionally.  So please let us know if you want some more ideas on handling this or other side effects. 

Till next time.  Take good care of yourself!