Chemotherapy induced diarrhea

Abstract

Diarrhea is a debilitating and potentially life-threatening side effect associated with many chemotherapeutic agents. Despite the high incidence and severity of CID, it is often under recognized and poorly managed. A multidisciplinary panel recently updated recommended practice guidelines for the assessment and management of CID. Prompt and aggressive intervention is important in order to minimize the negative consequences of CID, such as dehydration, which may cause interruptions in optimal clinical outcomes or may lead to life-threatening sequelae. Further investigation into the pathophysiology of CID may allow for more directed approaches in the prophylaxis and treatment of CID.

Bevacizumab plus irinotecan in the treatment patients with progressive recurrent malignant brain tumours

“…Adverse events were manageable in most cases. There was one treatment-related death (diarrhoea), a well known side effect of irinotecan [38]. There was a suggestion of increased risk of thromboembolic effects including one case each of cerebral haemorrhage, intestinal perforation and superficial venous thrombosis, which may have been related to and have been associated with bevacizumab [39].…”

Axitinib for the Treatment of Metastatic Renal Cell Carcinoma

“…The consistency and volume of stool and duration of diarrhea, presence of fever, or signs and symptoms of dehydration should all be assessed. 12 A careful medical and medication history may identify underlying causative or exacerbating factors. 12 Diarrhea can usually be managed by dietary modification and oral hydration/electrolyte replacement and through the use of antidiarrheal medications, such as loperamide on an asneeded basis.…”

“…12 A careful medical and medication history may identify underlying causative or exacerbating factors. 12 Diarrhea can usually be managed by dietary modification and oral hydration/electrolyte replacement and through the use of antidiarrheal medications, such as loperamide on an asneeded basis. 15,16 However, patients should not overuse antidiarrheals, as they can cause constipation, especially in patients taking opioids, and this can be even more troublesome for the patient than diarrhea.…”

“…13 Diarrhea may be worsened or caused by factors including diet, infection, other types of bowel pathology, concomitant medications, neuroendocrine factors (eg, hyperthyroidism and diabetes), and anxiety, highlighting the need for careful patient assessment. 12 Diarrhea is a frequent cause of dose reductions or interruptions and requires proactive management.…”

The Role of Supportive Therapy in the Era of Modern Adjuvant Treatment – Current and Future Tools

“…Although a high incidence of chemotherapy-induced diarrhoea is reported, the condition is often recognized late and poorly managed [63]. Fluid and electrolyte loss may result in dehydration and ultimately renal insufficiency, also the rate of infectious complications is increased [46].…”