@madlydancing you are in the terrible position of caregiver where you share the suffering of your spouse and must manage all the medical issues as well. With a palliative care team they should be able to manage pain, if he will be compliant with medications. Is he on any medications for his IBS? Has his gastroenterologist been contacted about the new inflammation from Keytruda plus chemo? When I was on an immunotherapy similar to Keytruda my oncologist warned of diarrhea as a side effect and that sometimes lowering the dose or using other medications to get this under control. Keep in touch with all of the team. I use Manuka honey daily and I know it can have a calming effect on the GI tract. You might want to research it. My husband was exhausted when he was on Keytruda for 4 months for bladder cancer, but no diarrhea.