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Gastrointestinal complications of oncologic therapy

Abstract

Gastrointestinal complications are common in patients undergoing various forms of cancer treatment, including chemotherapy, radiation therapy, and molecular-targeted therapies. Many of these complications are life-threatening and require prompt diagnosis and treatment. Complications of oncologic therapy can occur in the esophagus (esophagitis, strictures, bacterial, viral and fungal infections), upper gastrointestinal tract (mucositis, bleeding, nausea and vomiting), colon (diarrhea, graft–versus–host disease, colitis and constipation), liver (drug hepatotoxicity and graft–versus–host disease), and pancreas (pancreatitis). Treatment of the different gastrointestinal complications should be tailored to the individual patient and based on the underlying pathophysiology of the complication.

Key Points

  • Gastrointestinal complications of oncologic therapy are common and can affect all organs of the gastrointestinal tract; they are often life-threatening

  • Treatment of gastrointestinal complications of oncologic therapy should be individualized to take into account the patient's status and disease pathophysiology

  • Gastrointestinal complications of oncologic therapy are often multifactorial, involving direct toxicity and secondary events resulting from the immunosuppressive properties of given agents

  • Gastrointestinal complications of therapy must be differentiated from signs and symptoms of underlying disease

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Figure 1: Use of a self-expanding esophageal stent to manage an esophageal stricture.
Figure 2: Pseudomembranous colitis.

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Davila, M., Bresalier, R. Gastrointestinal complications of oncologic therapy. Nat Rev Gastroenterol Hepatol 5, 682–696 (2008). https://doi.org/10.1038/ncpgasthep1277

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