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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/pdqcis/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-pdqcis-lrg.png" alt="Cover of PDQ Cancer Information Summaries" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>PDQ Cancer Information Summaries [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK66002_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK66002_dtls__"><div>Bethesda (MD): <a href="http://www.cancer.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Cancer Institute (US)</a>; 2002-.</div></div><div class="half_rhythm"></div><div class="bk_noprnt"><form method="get" action="/books/n/pdqcis/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK66002_"><span class="title" itemprop="name">Gastrointestinal Complications (PDQ®)</span></h1><div class="subtitle whole_rhythm">Patient Version</div><p class="contrib-group"><span itemprop="author">PDQ Supportive and Palliative Care Editorial Board</span>.</p><p class="small">Published online: March 7, 2019.</p></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><div id="_abs_rndgid_" itemprop="description"><p id="CDR0000062834__237">This PDQ cancer information summary has current information about the causes and treatment of gastrointestinal complications, including constipation, impaction, bowel obstruction, diarrhea, and radiation enteritis. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p><p id="CDR0000062834__238">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Supportive and Palliative Care Editorial Board.</p></div><div id="CDR0000062834__1"><h2 id="_CDR0000062834__1_">General Information</h2><p id="CDR0000062834__221">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046189/" class="def">gastrointestinal (GI) tract</a> is part of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046446/" class="def">digestive system</a>, which processes <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044697/" class="def">nutrients</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044744/" class="def">vitamins</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045787/" class="def">minerals</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000285960/" class="def">carbohydrates</a>, fats, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046092/" class="def">proteins</a>, and water) in foods that are eaten and helps pass waste material out of the body. The GI tract includes the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046604/" class="def">stomach</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046335/" class="def">intestines</a> (bowels). The stomach is a J-shaped <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organ</a> in the upper <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>. Food moves from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000439429/" class="def">throat</a> to the stomach through a hollow, muscular tube called the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046408/" class="def">esophagus</a>. After leaving the stomach, partly-digested food passes into the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046582/" class="def">small intestine</a> and then into the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045097/" class="def">large intestine</a>.
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The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046462/" class="def">colon</a> (large <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046500/" class="def">bowel</a>) is the first part of the large intestine and is about 5 feet long. Together, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046555/" class="def">rectum</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044185/" class="def">anal</a> canal make up the last part of the large intestine and are 6-8 inches long. The anal canal ends at the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046523/" class="def">anus</a> (the opening of the large intestine to the outside of the body).<div id="CDR0000062834__235" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Anatomy%20of%20the%20lower%20digestive%20system%2C%20showing%20the%20colon%20and%20other%20organs&p=BOOKS&id=538396_CDR0000415499.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK66002.4/bin/CDR0000415499.jpg" alt="Gastrointestinal (digestive) system anatomy; shows esophagus, liver, stomach, colon, small intestine, rectum, and anus." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Anatomy of the lower digestive system, showing the colon and other organs.</p></div></div></p><p id="CDR0000062834__4">GI <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463706/" class="def">complications</a> are common in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> patients. Complications are medical problems that occur during a disease, or after a procedure or treatment. They may be caused by the disease, procedure, or treatment, or may have other causes. This summary describes the following GI complications and their causes and treatments:</p><ul id="CDR0000062834__46"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000407757/" class="def">Constipation</a>.</div></li><li class="half_rhythm"><div>Fecal impaction.</div></li><li class="half_rhythm"><div>Bowel obstruction.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000306496/" class="def">Diarrhea</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000446535/" class="def">Radiation enteritis</a>.</div></li></ul><p id="CDR0000062834__47">This summary is about GI complications in adults with cancer. Treatment of GI complications in children is different than treatment for adults. </p></div><div id="CDR0000062834__8"><h2 id="_CDR0000062834__8_">Constipation</h2><div id="CDR0000062834__8.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000062834__9"> With constipation, bowel movements are difficult or don’t happen as often as usual.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062834__12">Certain medicines, changes in diet, not drinking enough fluids, and being less active are common causes of constipation.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062834__60">An assessment is done to help plan treatment.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062834__64">Treating constipation is important to make the patient comfortable and to prevent more serious problems.</a></div></li></ul></div><div id="CDR0000062834__9"><h3> With constipation, bowel movements are difficult or don’t happen as often as usual.</h3><p id="CDR0000062834__11"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000407757/" class="def">Constipation</a> is the slow movement of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046605/" class="def">stool</a> through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045097/" class="def">large intestine</a>. The longer it takes for the stool to move through the large intestine, the more it loses <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044669/" class="def">fluid</a> and the drier and harder it becomes. The patient may be unable to have a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651179/" class="def">bowel movement</a>, have to push harder to have a bowel movement, or have fewer than their usual number of bowel movements. </p></div><div id="CDR0000062834__12"><h3>Certain medicines, changes in diet, not drinking enough fluids, and being less active are common causes of constipation.</h3><p id="CDR0000062834__161">Constipation is a common problem for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> patients. Cancer patients may become constipated by any of the usual factors that cause constipation in healthy people. These include older age, changes in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044660/" class="def">diet</a> and fluid intake, and not getting enough exercise. In addition to these common causes of constipation, there are other causes in cancer patients.
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</p><p id="CDR0000062834__49">Other causes of constipation include:</p><ul id="CDR0000062834__50" class="simple-list"><li class="half_rhythm"><div><b>Medicines</b><ul id="CDR0000062834__54"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045054/" class="def">Opioids</a> and other pain <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482419/" class="def">medicines</a>. This is one of the main causes of constipation in cancer patients.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a>.
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</div></li><li class="half_rhythm"><div>Medicines for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000430405/" class="def">anxiety</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000430479/" class="def">depression</a>.
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</div></li><li class="half_rhythm"><div>Antacids.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045298/" class="def">Diuretics</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a> that increase the amount of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046642/" class="def">urine</a> made by the body).
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000441266/" class="def">Supplements</a> such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000446805/" class="def">iron</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045632/" class="def">calcium</a>.
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</div></li><li class="half_rhythm"><div>Sleep medicines.
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</div></li><li class="half_rhythm"><div>Drugs used for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046050/" class="def">anesthesia</a> (to cause loss of feeling for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a> or other procedures).
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</div></li></ul></div></li><li class="half_rhythm"><div><b>Diet</b><ul id="CDR0000062834__51"><li class="half_rhythm"><div>Not drinking enough water or other fluids. This is a common problem for cancer patients.</div></li><li class="half_rhythm"><div>Not eating enough food, especially high-<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046401/" class="def">fiber</a> food.</div></li></ul></div></li><li class="half_rhythm"><div><b>Bowel movement habits</b><ul id="CDR0000062834__52"><li class="half_rhythm"><div>Not going to the bathroom when the need for a bowel movement is felt.
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</div></li><li class="half_rhythm"><div>Using <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000373085/" class="def">laxatives</a> and/or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044204/" class="def">enemas</a> too often.</div></li></ul></div></li><li class="half_rhythm"><div><b>Conditions that prevent activity and exercise</b><ul id="CDR0000062834__53"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000340937/" class="def">Spinal cord</a> injury or pressure on the spinal cord from a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> or other cause.</div></li><li class="half_rhythm"><div>Broken bones. </div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000321374/" class="def">Fatigue</a>.</div></li><li class="half_rhythm"><div>Weakness.</div></li><li class="half_rhythm"><div>Long periods of bed rest or not being active.
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</div></li><li class="half_rhythm"><div>Heart problems.</div></li><li class="half_rhythm"><div>Breathing problems.</div></li><li class="half_rhythm"><div>Anxiety.</div></li><li class="half_rhythm"><div>Depression.</div></li></ul></div></li><li class="half_rhythm"><div><b>Intestinal disorders</b><ul id="CDR0000062834__55"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000630910/" class="def">Irritable colon</a>.
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000630901/" class="def">Diverticulitis</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044042/" class="def">inflammation</a> of small pouches in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046462/" class="def">colon</a> called diverticula).</div></li><li class="half_rhythm"><div>Tumor in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046335/" class="def">intestine</a>.</div></li></ul></div></li><li class="half_rhythm"><div><b>Muscle and nerve disorders
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</b><ul id="CDR0000062834__57"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000387264/" class="def">Brain tumors</a>.</div></li><li class="half_rhythm"><div>Spinal cord injury or pressure on the spinal cord from a tumor or other cause.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046242/" class="def">Paralysis</a> (loss of ability to move) of both legs.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000439425/" class="def">Stroke</a> or other <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000407758/" class="def">disorders</a> that cause paralysis of part of the body.
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044705/" class="def">Peripheral neuropathy</a> (pain, numbness, tingling) of feet.</div></li><li class="half_rhythm"><div>Weakness of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046451/" class="def">diaphragm</a> (the breathing muscle below the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lungs</a>) or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046684/" class="def">abdominal</a> muscles. This makes it hard to push to have a bowel movement.</div></li></ul></div></li><li class="half_rhythm"><div><b>Changes in body metabolism</b><ul id="CDR0000062834__58"><li class="half_rhythm"><div>Having a low level of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044558/" class="def">thyroid hormone</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044344/" class="def">potassium</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044731/" class="def">sodium</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a>.
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</div></li><li class="half_rhythm"><div>Having too much nitrogen or calcium in the blood.
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</div></li></ul></div></li><li class="half_rhythm"><div><b>Environment </b><ul id="CDR0000062834__59"><li class="half_rhythm"><div>Having to go farther to get to a bathroom.</div></li><li class="half_rhythm"><div>Needing help to go to the bathroom.
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</div></li><li class="half_rhythm"><div>Being in unfamiliar places.</div></li><li class="half_rhythm"><div>Having little or no privacy.</div></li><li class="half_rhythm"><div>Feeling rushed.</div></li><li class="half_rhythm"><div>Living in extreme heat that causes <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044659/" class="def">dehydration</a>.</div></li><li class="half_rhythm"><div>Needing to use a bedpan or bedside commode.
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</div></li></ul></div></li><li class="half_rhythm"><div><b>Narrow colon</b><ul id="CDR0000062834__160"><li class="half_rhythm"><div>Scars from <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a> or surgery.</div></li><li class="half_rhythm"><div>Pressure from a growing tumor.
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</div></li></ul></div></li></ul></div><div id="CDR0000062834__60"><h3>An assessment is done to help plan treatment.</h3><p id="CDR0000062834__62">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000430407/" class="def">assessment</a> includes a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270871/" class="def">physical exam</a> and questions about the patient's usual bowel movements and how they have changed. </p><p id="CDR0000062834__207">The following tests and procedures may be done to help find the cause of the constipation:</p><ul id="CDR0000062834__157"><li class="half_rhythm"><div><b>Physical exam</b>: An exam of the body to check general <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> of health, including checking for signs of disease, such as lumps or anything else that seems unusual. The doctor will check for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046500/" class="def">bowel</a> sounds and swollen, painful <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>. </div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045668/" class="def">Digital rectal exam</a> (DRE)</b>: An exam of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046555/" class="def">rectum</a>. The doctor or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269445/" class="def">nurse</a> inserts a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046302/" class="def">lubricated</a>, gloved finger into the lower part of the rectum to feel for lumps or anything else that seems unusual. In women, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046646/" class="def">vagina</a> may also be examined.
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</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045050/" class="def">Fecal occult blood test</a></b>: A test to check stool for blood that can only be seen with a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a>. Small samples of stool are placed on special cards and returned to the doctor or laboratory for testing.<div id="CDR0000062834__229" class="figure bk_fig"><div class="graphic"><img src="/books/NBK66002.4/bin/CDR0000415502.jpg" alt="Guaiac fecal occult blood test (FOBT) kit; shows card, applicator, and return envelope." /></div><div class="caption"><p>A guaiac fecal occult blood test (FOBT) checks for occult (hidden) blood in the stool. Small samples of stool are placed on a special card and returned to a doctor or laboratory for testing.</p></div></div></div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046535/" class="def">Proctoscopy</a></b>: A procedure to look inside the rectum and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046523/" class="def">anus</a> to check for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044636/" class="def">abnormal</a> areas, using a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000742474/" class="def">proctoscope</a>. A proctoscope is a thin, tube-like instrument with a light and a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000572035/" class="def">lens</a> for viewing the inside of the rectum and anus. It may also have a tool to remove <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> samples, which are checked under a microscope for signs of cancer.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045648/" class="def">Colonoscopy</a></b>: A procedure to look inside the rectum and colon for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045844/" class="def">polyps</a>, abnormal areas, or cancer. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046463/" class="def">colonoscope</a> is inserted through the rectum into the colon. A colonoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove polyps or tissue samples, which are checked under a microscope for signs of cancer.<div id="CDR0000062834__236" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Colonoscopy&p=BOOKS&id=538396_CDR0000415504.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK66002.4/bin/CDR0000415504.jpg" alt="Colonoscopy; shows colonoscope inserted through the anus and rectum and into the colon. Inset shows patient on table having a colonoscopy." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Colonoscopy. A thin, lighted tube is inserted through the anus and rectum and into the colon to look for abnormal areas.</p></div></div></div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000455670/" class="def">Abdominal x-ray</a></b>: An <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-ray</a> of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organs</a> inside the abdomen. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.</div></li></ul><p id="CDR0000062834__158"> There is no “normal” number of bowel movements for a cancer patient. Each person is different. You will be asked about bowel routines, food, and
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medicines:</p><ul id="CDR0000062834__63"><li class="half_rhythm"><div>How often do you have a bowel movement? When and how much?</div></li><li class="half_rhythm"><div>When was your last bowel movement? What was it like (how much, hard or soft, color)?</div></li><li class="half_rhythm"><div>Was there any blood in your stool?
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</div></li><li class="half_rhythm"><div>Has your <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046604/" class="def">stomach</a> hurt or have you had any cramps, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390302/" class="def">nausea</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390324/" class="def">vomiting</a>, gas, or feeling of fullness near the rectum?
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</div></li><li class="half_rhythm"><div>Do you use laxatives or enemas regularly? </div></li><li class="half_rhythm"><div>What do you usually do to relieve constipation? Does this usually work?
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</div></li><li class="half_rhythm"><div>What kind of food do you eat? </div></li><li class="half_rhythm"><div>How much and what type of fluids do you drink each day?
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</div></li><li class="half_rhythm"><div>What medicines are you taking? How much and how often?
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</div></li><li class="half_rhythm"><div>Is this constipation a recent change in your normal habits?
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</div></li><li class="half_rhythm"><div>How many times a day do you pass gas?</div></li></ul><p id="CDR0000062834__200">For patients who have <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046464/" class="def">colostomies</a>, care of the colostomy will be discussed.</p></div><div id="CDR0000062834__64"><h3>Treating constipation is important to make the patient comfortable and to prevent more serious problems.</h3><p id="CDR0000062834__66">It's easier to prevent constipation than to relieve it. The health care team will work with the patient to prevent constipation. Patients who take opioids may need to start taking laxatives right away to prevent constipation.</p><p id="CDR0000062834__163">Constipation can be very uncomfortable and cause <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454701/" class="def">distress</a>. If left untreated, constipation may lead to fecal impaction. This is a serious <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">condition</a> in which stool will not pass out of the colon or rectum.
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It's important to treat constipation to prevent fecal impaction.</p><p id="CDR0000062834__164"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000439419/" class="def">Prevention</a> and treatment are not the same for every patient. Do the following to prevent and treat constipation:</p><ul id="CDR0000062834__67"><li class="half_rhythm"><div>Keep a record of all bowel movements.
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</div></li><li class="half_rhythm"><div>Drink eight 8-<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000330174/" class="def">ounce</a> glasses of fluid each day. Patients who have certain conditions, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046325/" class="def">kidney</a> or heart disease, may need to drink less.
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</div></li><li class="half_rhythm"><div>Get regular exercise. Patients who cannot walk may do abdominal exercises in bed or move from the bed to a chair.
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</div></li><li class="half_rhythm"><div>Increase the amount of fiber in the diet by eating more of the following:<dl id="CDR0000062834__165" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">Fruits, such as raisins, prunes, peaches, and apples.</p></dd><dt>-</dt><dd><p class="no_top_margin">Vegetables, such as squash, broccoli, carrots, and celery. </p></dd><dt>-</dt><dd><p class="no_top_margin">Whole grain cereals, whole grain breads, and bran.</p></dd></dl> It's important to drink more fluids when eating more high-fiber foods, to avoid making constipation worse. Patients who have had a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046582/" class="def">small</a> or large intestinal obstruction or have had intestinal surgery (for example, a colostomy) should not eat a high-fiber diet.
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</div></li><li class="half_rhythm"><div>Drink a warm or hot drink about one half-hour before the usual time for a bowel movement.
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</div></li><li class="half_rhythm"><div>Find privacy and quiet when it is time for a bowel movement.
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</div></li><li class="half_rhythm"><div>Use the toilet or a bedside commode instead of a bedpan.
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</div></li><li class="half_rhythm"><div>Take only medicines that are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044711/" class="def">prescribed</a> by the doctor.
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Medicines for constipation may include bulking agents, laxatives, stool softeners, and drugs that cause the intestine to empty.</div></li><li class="half_rhythm"><div>Use suppositories or enemas only if ordered by the doctor. In some cancer patients, these treatments may lead to bleeding, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045364/" class="def">infection</a>, or other harmful <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a>.</div></li></ul><p id="CDR0000062834__166">When constipation is caused by opioids, treatment may be drugs that stop the effects of the opioids or other medicines, stool softeners, enemas, and/or manual removal of stool.</p></div></div><div id="CDR0000062834__15"><h2 id="_CDR0000062834__15_">Fecal Impaction</h2><div id="CDR0000062834__15.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000062834__16">Fecal impaction is a mass of dry, hard stool that will not pass out of the colon or rectum.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062834__19">A common cause of fecal impaction is using laxatives too often. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062834__70">Symptoms of fecal impaction include being unable to have a bowel movement and pain in the abdomen or back.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062834__73">Assessment includes a physical exam and questions like those asked in the assessment of constipation.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062834__76">A fecal impaction is usually treated with an enema.</a></div></li></ul></div><div id="CDR0000062834__16"><h3>Fecal impaction is a mass of dry, hard stool that will not pass out of the colon or rectum.</h3><p id="CDR0000062834__18">Fecal impaction is dry <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046605/" class="def">stool</a> that cannot pass out of the body. Patients with fecal impaction may not have <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045692/" class="def">gastrointestinal</a> (GI) <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a>. Instead, they may have problems with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476484/" class="def">circulation</a>, the heart, or breathing. If fecal impaction is not treated, it can get worse and cause death.</p></div><div id="CDR0000062834__19"><h3>A common cause of fecal impaction is using laxatives too often. </h3><p id="CDR0000062834__69">Repeated use of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000373085/" class="def">laxatives</a> in higher and higher <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044664/" class="def">doses</a> makes the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046462/" class="def">colon</a> less able to respond naturally to the need to have a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651179/" class="def">bowel movement</a>. This is a common reason for fecal impaction. Other causes include:</p><ul id="CDR0000062834__68"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045054/" class="def">Opioid</a> pain <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482419/" class="def">medicines</a>.</div></li><li class="half_rhythm"><div>
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Little or no activity over a long period.
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044660/" class="def">Diet</a> changes.
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000407757/" class="def">Constipation</a> that is not treated. See the section above on <a href="#CDR0000062834__12">causes of constipation</a>.</div></li></ul><p id="CDR0000062834__227">Certain types of mental illness may lead to fecal impaction.</p></div><div id="CDR0000062834__70"><h3>Symptoms of fecal impaction include being unable to have a bowel movement and pain in the abdomen or back.</h3><p id="CDR0000062834__155">The following may be symptoms of fecal impaction:</p><ul id="CDR0000062834__72"><li class="half_rhythm"><div>Being unable to have a bowel movement.</div></li><li class="half_rhythm"><div>Having to push harder to have a bowel movement of small amounts of hard, dry stool.</div></li><li class="half_rhythm"><div>Having fewer than the usual number of bowel movements.</div></li><li class="half_rhythm"><div>Having pain in the back or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>. </div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046642/" class="def">Urinating</a> more or less often than usual, or being unable to urinate.</div></li><li class="half_rhythm"><div>Breathing problems, rapid heartbeat, dizziness, low <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000462668/" class="def">blood pressure</a>, and swollen abdomen. </div></li><li class="half_rhythm"><div>Having sudden, explosive <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000306496/" class="def">diarrhea</a> (as stool moves around the impaction). </div></li><li class="half_rhythm"><div>Leaking stool when coughing.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390302/" class="def">Nausea</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390324/" class="def">vomiting</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044659/" class="def">Dehydration</a>. </div></li><li class="half_rhythm"><div>Being confused and losing a sense of time and place, with rapid heartbeat, sweating, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000450108/" class="def">fever</a>, and high or low blood pressure.</div></li></ul><p id="CDR0000062834__222">These symptoms should be reported to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000650566/" class="def">health care provider</a>. </p></div><div id="CDR0000062834__73"><h3>Assessment includes a physical exam and questions like those asked in the assessment of constipation.</h3><p id="CDR0000062834__75">The doctor will ask questions similar to those for the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000430407/" class="def">assessment</a> of constipation:</p><ul id="CDR0000062834__225"><li class="half_rhythm"><div>How often do you have a bowel movement? When and how much?</div></li><li class="half_rhythm"><div>When was your last bowel movement? What was it like (how much, hard or soft, color)?</div></li><li class="half_rhythm"><div>Was there any <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a> in your stool?
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</div></li><li class="half_rhythm"><div>Has your <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046604/" class="def">stomach</a> hurt or have you had any cramps, nausea, vomiting, gas, or feeling of fullness near the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046555/" class="def">rectum</a>?</div></li><li class="half_rhythm"><div>Do you use laxatives or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044204/" class="def">enemas</a> regularly? </div></li><li class="half_rhythm"><div>What do you usually do to relieve constipation? Does this usually work?
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</div></li><li class="half_rhythm"><div>What kind of food do you eat?</div></li><li class="half_rhythm"><div>How much and what type of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044669/" class="def">fluids</a> do you drink each day?</div></li><li class="half_rhythm"><div>What medicines are you taking? How much and how often?
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</div></li><li class="half_rhythm"><div>Is this constipation a recent change in your normal habits?
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</div></li><li class="half_rhythm"><div>How many times a day do you pass gas?</div></li></ul><p id="CDR0000062834__226">The doctor will do a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270871/" class="def">physical exam</a> to find out if the patient has a fecal impaction. The following tests and procedures may be done:</p><ul id="CDR0000062834__188"><li class="half_rhythm"><div><b>Physical exam</b>: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. </div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">X-rays</a></b>: An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
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To check for fecal impaction, x-rays of the abdomen or chest may be done.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045668/" class="def">Digital rectal exam</a> (DRE)</b>: An exam of the rectum. The doctor or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269445/" class="def">nurse</a> inserts a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046302/" class="def">lubricated</a>, gloved finger into the lower part of the rectum to feel for a fecal impaction, lumps, or anything else that seems unusual. </div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045880/" class="def">Sigmoidoscopy</a></b>: A procedure to look inside the rectum and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000357588/" class="def">sigmoid (lower) colon</a> for a fecal impaction, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045844/" class="def">polyps</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044636/" class="def">abnormal</a> areas, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046680/" class="def">sigmoidoscope</a> is inserted through the rectum into the sigmoid colon. A sigmoidoscope is a thin, tube-like instrument with a light and a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000572035/" class="def">lens</a> for viewing. It may also have a tool to remove polyps or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> samples, which are checked under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> for signs of cancer. <div id="CDR0000062834__231" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Sigmoidoscopy&p=BOOKS&id=538396_CDR0000415503.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK66002.4/bin/CDR0000415503.jpg" alt="Sigmoidoscopy; shows sigmoidoscope inserted through the anus and rectum and into the sigmoid colon. Inset shows patient on table having a sigmoidoscopy." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Sigmoidoscopy. A thin, lighted tube is inserted through the anus and rectum and into the lower part of the colon to look for abnormal areas.</p></div></div></div></li><li class="half_rhythm"><div><b>Blood tests</b>: Tests done on a sample of blood to measure the amount of certain substances in the blood or to count different types of blood <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a>. Blood tests may be done to look for signs of disease or agents that cause disease, to check for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044918/" class="def">antibodies</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046636/" class="def">tumor markers</a>, or to see how well treatments are working. </div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000635410/" class="def">Electrocardiogram</a> (EKG)</b>: A test that shows the activity of the heart. Small electrodes are placed on the skin of the chest, wrists, and ankles and are attached to an electrocardiograph. The electrocardiograph makes a line graph that shows changes in the electrical activity of the heart over time. The graph can show abnormal <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">conditions</a>, such as blocked <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000440100/" class="def">arteries</a>, changes in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044338/" class="def">electrolytes</a> (particles with electrical charges), and changes in the way electrical currents pass through the heart tissue.</div></li></ul></div><div id="CDR0000062834__76"><h3>A fecal impaction is usually treated with an enema.</h3><p id="CDR0000062834__78">The main treatment for impaction is to moisten and soften the stool so it can be removed or passed out of the body. This is usually done with an enema. Enemas are given only as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044711/" class="def">prescribed</a> by the doctor since too many enemas can damage the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046335/" class="def">intestine</a>. Stool softeners or glycerin suppositories may be given to make the stool softer and easier to pass. Some patients may need to have stool manually removed from the rectum after it is softened. </p><p id="CDR0000062834__174">Laxatives that cause the stool to move are not used because they can also damage the intestine.</p></div></div><div id="CDR0000062834__22"><h2 id="_CDR0000062834__22_">Bowel Obstruction</h2><div id="CDR0000062834__22.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000062834__23">A bowel obstruction is a blockage of the small or large intestine by something other than fecal impaction.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062834__26">The most common cancers that cause bowel obstructions are cancers of the colon, stomach, and ovary.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062834__79">Assessment includes a physical exam and imaging tests.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062834__82">Treatment is different for acute and chronic bowel obstructions.</a></div><ul><li class="half_rhythm"><div><a href="#CDR0000062834__84">Acute bowel obstruction</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062834__88">Chronic, malignant bowel obstruction</a></div></li></ul></li></ul></div><div id="CDR0000062834__23"><h3>A bowel obstruction is a blockage of the small or large intestine by something other than fecal impaction.</h3><p id="CDR0000062834__25"> Bowel obstructions (blockages) keep the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046605/" class="def">stool</a> from moving through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046582/" class="def">small</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045097/" class="def">large intestines</a>. They may be caused by a physical change or by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">conditions</a> that stop the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044046/" class="def">intestinal</a> muscles from moving normally. The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046335/" class="def">intestine</a> may be partly or completely blocked. Most obstructions occur in the small intestine.</p><p id="CDR0000062834__212"><b>Physical changes</b></p><ul id="CDR0000062834__213"><li class="half_rhythm"><div>The intestine may become twisted or form a loop, closing it off and trapping stool.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044042/" class="def">Inflammation</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000640078/" class="def">scar tissue</a> from <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000630906/" class="def">hernias</a> can make the intestine too narrow.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">Tumors</a> growing inside or outside the intestine can cause it to be partly or completely blocked.</div></li></ul><p id="CDR0000062834__214">If the intestine is blocked by physical causes, it may decrease <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a> flow to blocked parts. Blood flow needs to be corrected or the affected <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> may die. </p><p id="CDR0000062834__215"><b>Conditions that affect the intestinal muscle</b></p><ul id="CDR0000062834__216"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046242/" class="def">Paralysis</a> (loss of ability to move).</div></li><li class="half_rhythm"><div>Blocked <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045020/" class="def">blood vessels</a> going to the intestine.</div></li><li class="half_rhythm"><div>Too little <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044344/" class="def">potassium</a> in the blood.</div></li></ul></div><div id="CDR0000062834__26"><h3>The most common cancers that cause bowel obstructions are cancers of the colon, stomach, and ovary.</h3><p id="CDR0000062834__28"> Other <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancers</a>, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000445043/" class="def">lung</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000444971/" class="def">breast cancers</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045135/" class="def">melanoma</a>, can spread to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a> and cause bowel obstruction. Patients who have had surgery on the abdomen or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a> to the abdomen have a higher risk of a bowel obstruction. Bowel obstructions are most common during the advanced <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stages</a> of cancer.</p></div><div id="CDR0000062834__79"><h3>Assessment includes a physical exam and imaging tests.</h3><p id="CDR0000062834__81">The following tests and procedures may be done to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a> a bowel obstruction: </p><ul id="CDR0000062834__204"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270871/" class="def">Physical exam</a></b>: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. The doctor will check to see if the patient has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046684/" class="def">abdominal</a> pain, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390324/" class="def">vomiting</a>, or any movement of gas or stool in the bowel.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045107/" class="def">Complete blood count</a> (CBC)</b>: A procedure in which a sample of blood is drawn and checked for the following:<dl id="CDR0000062834__219" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">
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The number of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046124/" class="def">red blood cells</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045993/" class="def">white blood cells</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045840/" class="def">platelets</a>.</p></dd><dt>-</dt><dd><p class="no_top_margin">The amount of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045108/" class="def">hemoglobin</a> (the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046092/" class="def">protein</a> that carries <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000538149/" class="def">oxygen</a>) in the red blood <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a>.</p></dd><dt>-</dt><dd><p class="no_top_margin">The portion of the blood sample made up of red blood cells.
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</p></dd></dl></div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044338/" class="def">Electrolyte</a> panel</b>: A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000688783/" class="def">blood test</a> that measures the levels of electrolytes, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044731/" class="def">sodium</a>, potassium, and chloride. </div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046641/" class="def">Urinalysis</a></b>: A test to check the color of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046642/" class="def">urine</a> and its contents, such as sugar, protein, red blood cells, and white blood cells.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000455670/" class="def">Abdominal x-ray</a></b>: An <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-ray</a> of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organs</a> inside the abdomen. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046513/" class="def">Barium enema</a></b>: A series of x-rays of the lower <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046189/" class="def">gastrointestinal tract</a>. A liquid that contains <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000739782/" class="def">barium</a> (a silver-white <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463718/" class="def">metallic</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000422394/" class="def">compound</a>) is put into the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046555/" class="def">rectum</a>. The barium coats the lower gastrointestinal tract and x-rays are taken. This procedure is also called a lower GI series. This test may show what part of the intestine is blocked. <div id="CDR0000062834__232" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Barium%20enema%20procedure&p=BOOKS&id=538396_CDR0000415505.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK66002.4/bin/CDR0000415505.jpg" alt="Barium enema procedure; shows barium liquid being put into the rectum and flowing through the colon. Inset shows person on table having a barium enema." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Barium enema procedure. The patient lies on an x-ray table. Barium liquid is put into the rectum and flows through the colon. X-rays are taken to look for abnormal areas.</p></div></div></div></li></ul></div><div id="CDR0000062834__82"><h3>Treatment is different for acute and chronic bowel obstructions.</h3><div id="CDR0000062834__84"><h4>Acute bowel obstruction</h4><p id="CDR0000062834__86"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045585/" class="def">Acute</a> bowel obstructions occur suddenly, may have not occurred before, and are not long-lasting. Treatment may include the following: </p><ul id="CDR0000062834__172"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000742478/" class="def">Fluid replacement therapy</a>: A treatment to get the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044669/" class="def">fluids</a> in the body back to normal amounts. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046682/" class="def">Intravenous</a> (IV) fluids may be given and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482419/" class="def">medicines</a> may be <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044711/" class="def">prescribed</a>.</div></li><li class="half_rhythm"><div>Electrolyte correction: A treatment to get the right amounts of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000643008/" class="def">chemicals</a> in the blood, such as sodium, potassium, and chloride. Fluids with electrolytes may be given by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045738/" class="def">infusion</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045991/" class="def">Blood transfusion</a>: A procedure in which a person is given an infusion of whole blood or parts of blood. </div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000644739/" class="def">Nasogastric</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046685/" class="def">colorectal</a> tube: A nasogastric tube is inserted through the nose and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046408/" class="def">esophagus</a> into the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046604/" class="def">stomach</a>. A colorectal tube is inserted through the rectum into the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046462/" class="def">colon</a>. This is done to decrease swelling, remove fluid and gas buildup, and relieve pressure. </div></li><li class="half_rhythm"><div>Surgery: Surgery to relieve the obstruction may be done if it causes serious <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> that are not relieved by other treatments.</div></li></ul><p id="CDR0000062834__205">Patients with symptoms that keep getting worse will have <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044671/" class="def">follow-up</a> exams to check for signs and symptoms of shock and to make sure the obstruction isn't getting worse. </p></div><div id="CDR0000062834__88"><h4>Chronic, malignant bowel obstruction</h4><p id="CDR0000062834__90"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045641/" class="def">Chronic</a> bowel obstructions keep getting worse over time. Patients who have <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000478743/" class="def">advanced cancer</a> may have chronic bowel obstructions that cannot be removed with surgery. The intestine may be blocked or narrowed in more than one place or the tumor may be too large to remove completely. Treatments include the following: </p><ul id="CDR0000062834__173"><li class="half_rhythm"><div>Surgery: The obstruction is removed to relieve pain and improve the patient's <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044903/" class="def">Stent</a>: A metal tube inserted into the intestine to open the area that is blocked.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476330/" class="def">Gastrostomy tube</a>: A tube inserted through the wall of the abdomen directly into the stomach. The gastrostomy tube can relieve fluid and air build-up in the stomach and allow medications and liquids to be given directly into the stomach by pouring them down the tube. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000407759/" class="def">drainage</a> bag with a valve may also be attached to the gastrostomy tube. When the valve is open, the patient may be able to eat or drink by mouth and the food drains directly into the bag. This gives the patient the experience of tasting the food and keeping the mouth moist. Solid food is avoided because it may block the tubing to the drainage bag.</div></li><li class="half_rhythm"><div>Medicines: <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">Injections</a> or infusions of medicines for pain, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390302/" class="def">nausea</a> and vomiting, and/or to make the intestines empty. This may be prescribed for patients who cannot be helped with a stent or gastrostomy tube.</div></li></ul></div></div></div><div id="CDR0000062834__29"><h2 id="_CDR0000062834__29_">Diarrhea</h2><div id="CDR0000062834__29.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000062834__30">Diarrhea is frequent, loose, and watery bowel movements.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062834__95">In cancer patients, the most common cause of diarrhea is cancer treatment.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062834__98">Assessment includes a physical exam, lab tests, and questions about diet and bowel movements. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062834__101">Treatment of diarrhea depends on what is causing it.</a></div></li></ul></div><div id="CDR0000062834__30"><h3>Diarrhea is frequent, loose, and watery bowel movements.</h3><p id="CDR0000062834__32"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000306496/" class="def">Diarrhea</a> is frequent, loose, and watery <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651179/" class="def">bowel movements</a>. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045585/" class="def">Acute</a> diarrhea lasts more than 4 days but less than 2 weeks. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">Symptoms</a> of acute diarrhea may be loose <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046605/" class="def">stools</a> and passing more than 3 unformed stools in one day. Diarrhea is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045641/" class="def">chronic</a> (long-term) when it goes on for longer than 2 months.
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</p><p id="CDR0000062834__93">Diarrhea can occur at any time during <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> treatment. It can be physically and emotionally <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000450122/" class="def">stressful</a> for patients who have cancer. </p></div><div id="CDR0000062834__95"><h3>In cancer patients, the most common cause of diarrhea is cancer treatment.</h3><p id="CDR0000062834__217">Causes of diarrhea in cancer patients include the following:</p><ul id="CDR0000062834__210"><li class="half_rhythm"><div>Cancer treatments, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">targeted therapy</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045263/" class="def">bone marrow transplant</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>.<dl id="CDR0000062834__223" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">Some chemotherapy and targeted therapy <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a> cause diarrhea by changing how <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044697/" class="def">nutrients</a> are broken down and absorbed in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046582/" class="def">small intestine</a>. More than half of patients who receive chemotherapy have diarrhea that needs to be treated. </p></dd><dt>-</dt><dd><p class="no_top_margin">Radiation therapy to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046246/" class="def">pelvis</a> can cause <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044042/" class="def">inflammation</a> of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046500/" class="def">bowel</a>. Patients may have problems digesting food, and have gas, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476585/" class="def">bloating</a>, cramps, and diarrhea. These symptoms may last up to 8 to 12 weeks after treatment or may not happen for months or years. Treatment may include <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044660/" class="def">diet</a> changes, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482419/" class="def">medicines</a>, or surgery. </p></dd><dt>-</dt><dd><p class="no_top_margin">Patients who are having radiation therapy and chemotherapy often have severe diarrhea. Hospital treatment may not be needed. Treatment may be given at an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044520/" class="def">outpatient</a> clinic or with home care. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046682/" class="def">Intravenous</a> (IV) <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044669/" class="def">fluids</a> may be given or medicines may be <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044711/" class="def">prescribed</a>.</p></dd><dt>-</dt><dd><p class="no_top_margin">Patients who have a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000643010/" class="def">donor</a> bone marrow transplant may develop <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045703/" class="def">graft-versus-host disease</a> (GVHD). <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046604/" class="def">Stomach</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044046/" class="def">intestinal</a> symptoms of GVHD include <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390302/" class="def">nausea</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390324/" class="def">vomiting</a>, severe <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046684/" class="def">abdominal</a> pain and cramps, and watery, green diarrhea. Symptoms may show up 1 week to 3 months after the transplant. </p></dd><dt>-</dt><dd><p class="no_top_margin">Surgery on the stomach or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046335/" class="def">intestines</a>.</p></dd></dl></div></li><li class="half_rhythm"><div>The cancer itself.
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</div></li><li class="half_rhythm"><div>Stress and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000430405/" class="def">anxiety</a> from being <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnosed</a> with cancer and having cancer treatment.</div></li><li class="half_rhythm"><div>Medical <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">conditions</a> and diseases other than cancer.
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045364/" class="def">Infections</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045967/" class="def">Antibiotic therapy</a> for certain infections. Antibiotic therapy can irritate the lining of the bowel and cause diarrhea that often does not get better with treatment.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000373085/" class="def">Laxatives</a>.
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</div></li><li class="half_rhythm"><div>Fecal impaction in which the stool leaks around the blockage.</div></li><li class="half_rhythm"><div>Certain foods that are high in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046401/" class="def">fiber</a> or fat.</div></li></ul></div><div id="CDR0000062834__98"><h3>Assessment includes a physical exam, lab tests, and questions about diet and bowel movements. </h3><p id="CDR0000062834__100">Because diarrhea can be life-threatening, it is important to find out the cause so treatment can begin as soon as possible. The doctor may ask the following questions to help plan treatment:</p><ul id="CDR0000062834__120"><li class="half_rhythm"><div>How often have you had bowel movements in the past 24 hours?
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</div></li><li class="half_rhythm"><div>When was your last bowel movement? What was it like (how much, how hard or soft, what color)? Was there any <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a>?</div></li><li class="half_rhythm"><div>Was there any blood in your stool or any <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044083/" class="def">rectal</a> bleeding?</div></li><li class="half_rhythm"><div>Have you been dizzy, very drowsy, or had any cramps, pain, nausea, vomiting, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000450108/" class="def">fever</a>?
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</div></li><li class="half_rhythm"><div>What have you eaten? What and how much have you had to drink in the past 24 hours?
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</div></li><li class="half_rhythm"><div>Have you lost weight recently? How much?
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</div></li><li class="half_rhythm"><div>How often have you urinated in the past 24 hours?
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</div></li><li class="half_rhythm"><div>What medicines are you taking? How much and how often?</div></li><li class="half_rhythm"><div>
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Have you traveled recently? </div></li></ul><p id="CDR0000062834__121">Tests and procedures may include the following:</p><ul id="CDR0000062834__218"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270871/" class="def">Physical exam</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000689078/" class="def">history</a></b>: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
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The exam will include checking <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000462668/" class="def">blood pressure</a>, pulse, and breathing; checking for dryness of the skin and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> lining the inside of the mouth; and checking for abdominal pain and bowel sounds.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045668/" class="def">Digital rectal exam</a> (DRE)</b>: An exam of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046555/" class="def">rectum</a>. The doctor or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269445/" class="def">nurse</a> inserts a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046302/" class="def">lubricated</a>, gloved finger into the lower part of the rectum to feel for lumps or anything else that seems unusual. The exam will check for signs of fecal impaction. Stool may be collected for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046590/" class="def">laboratory tests</a>. </div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045050/" class="def">Fecal occult blood test</a></b>: A test to check stool for blood that can only be seen with a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a>. Small samples of stool are placed on special cards and returned to the doctor or laboratory for testing.</div></li><li class="half_rhythm"><div><b>Stool tests</b>: Laboratory tests to check the water and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044731/" class="def">sodium</a> levels in stool, and to find substances that may be causing diarrhea. Stool is also checked for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044123/" class="def">bacterial</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044571/" class="def">fungal</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044629/" class="def">viral</a> infections.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045107/" class="def">Complete blood count</a> (CBC)</b>: A procedure in which a sample of blood is drawn and checked for the following:<dl id="CDR0000062834__220" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">
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The number of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046124/" class="def">red blood cells</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045993/" class="def">white blood cells</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045840/" class="def">platelets</a>.</p></dd><dt>-</dt><dd><p class="no_top_margin">The amount of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045108/" class="def">hemoglobin</a> (the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046092/" class="def">protein</a> that carries <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000538149/" class="def">oxygen</a>) in the red blood cells.</p></dd><dt>-</dt><dd><p class="no_top_margin">The portion of the blood sample made up of red blood cells.
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</p></dd></dl></div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044338/" class="def">Electrolyte</a> panel</b>: A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000688783/" class="def">blood test</a> that measures the levels of electrolytes, such as sodium, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044344/" class="def">potassium</a>, and chloride. </div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046641/" class="def">Urinalysis</a></b>: A test to check the color of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046642/" class="def">urine</a> and its contents, such as sugar, protein, red blood cells, and white blood cells.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000455670/" class="def">Abdominal x-ray</a></b>: An <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-ray</a> of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organs</a> inside the abdomen. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body. Abdominal x-rays may also be done to look for a bowel obstruction or other problems.
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</div></li></ul></div><div id="CDR0000062834__101"><h3>Treatment of diarrhea depends on what is causing it.</h3><p id="CDR0000062834__103">Treatment depends on the cause of the diarrhea. The doctor may make changes in medicines, diet, and/or fluids. </p><ul id="CDR0000062834__208"><li class="half_rhythm"><div>A change in the use of laxatives may be needed. </div></li><li class="half_rhythm"><div>Medicine to treat diarrhea may be prescribed to slow down the intestines, decrease fluid secreted by the intestines, and help nutrients be absorbed.</div></li><li class="half_rhythm"><div>Diarrhea caused by cancer treatment may be treated by changes in diet. Eat small frequent meals and avoid the following foods:<dl id="CDR0000062834__124" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">Milk and dairy products.</p></dd><dt>-</dt><dd><p class="no_top_margin">Spicy foods.
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</p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463134/" class="def">Alcohol</a>.</p></dd><dt>-</dt><dd><p class="no_top_margin">Foods and drinks that have <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454809/" class="def">caffeine</a>.
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</p></dd><dt>-</dt><dd><p class="no_top_margin">Certain fruit juices.
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</p></dd><dt>-</dt><dd><p class="no_top_margin">Foods and drinks that cause gas.
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</p></dd><dt>-</dt><dd><p class="no_top_margin">Foods high in fiber or fat.</p></dd></dl></div></li><li class="half_rhythm"><div>A diet of bananas, rice, apples, and toast (the BRAT diet) may help mild diarrhea.</div></li><li class="half_rhythm"><div>
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Drinking more clear liquids may help decrease diarrhea. It is best to drink up to 3 quarts of clear fluids a day. These include water, sports drinks, broth, weak decaffeinated tea, caffeine-free soft drinks, clear juices, and gelatin. For severe diarrhea, the patient may need intravenous (IV) fluids or other forms of IV <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044698/" class="def">nutrition</a>. </div></li><li class="half_rhythm"><div>Diarrhea caused by graft-versus-host-disease (GVHD) is often treated with a special diet. Some patients may need long-term treatment and diet management.
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000658861/" class="def">Probiotics</a> may be recommended. Probiotics are live <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044059/" class="def">microorganisms</a> used as a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000373932/" class="def">dietary supplement</a> to help with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463707/" class="def">digestion</a> and normal <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000446980/" class="def">bowel function</a>. A bacterium found in yogurt called <i><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000658830/" class="def">Lactobacillus</a> acidophilus</i>, is the most common probiotic.</div></li><li class="half_rhythm"><div>Patients who have diarrhea with other symptoms may need fluids and medicine given by IV. </div></li></ul></div></div><div id="CDR0000062834__36"><h2 id="_CDR0000062834__36_">Radiation Enteritis</h2><div id="CDR0000062834__36.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000062834__37">Radiation enteritis is inflammation of the intestine caused by radiation therapy.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062834__110">Symptoms may begin during radiation therapy or months to years later.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062834__186">The total dose of radiation and other factors affect the risk of radiation enteritis.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062834__107">Acute and chronic enteritis have symptoms that are a lot alike.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062834__40">Assessment of radiation enteritis includes a physical exam and questions for the patient. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062834__114">Treatment depends on whether the radiation enteritis is acute or chronic. </a></div><ul><li class="half_rhythm"><div><a href="#CDR0000062834__139">Acute radiation enteritis </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062834__146">Chronic radiation enteritis </a></div></li></ul></li></ul></div><div id="CDR0000062834__37"><h3>Radiation enteritis is inflammation of the intestine caused by radiation therapy.</h3><p id="CDR0000062834__39"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000446535/" class="def">Radiation enteritis</a> is a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">condition</a> in which the lining of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046335/" class="def">intestine</a> becomes swollen and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044042/" class="def">inflamed</a> during or after <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a> to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046246/" class="def">pelvis</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046555/" class="def">rectum</a>. The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046582/" class="def">small</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045097/" class="def">large intestine</a> are very sensitive to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045072/" class="def">radiation</a>. The larger the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044664/" class="def">dose</a> of radiation, the more damage may be done to normal <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a>. Most <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumors</a> in the abdomen and pelvis need large doses of radiation. Almost all patients receiving radiation to the abdomen, pelvis, or rectum will have enteritis.</p><p id="CDR0000062834__106"><div class="milestone-start" id="CDR0000062834__104"></div>Radiation therapy to kill <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> in the abdomen and pelvis affects normal cells in the lining of the intestines. Radiation therapy stops the growth of cancer cells and other fast-growing cells. Since normal cells in the lining of the intestines grow quickly, radiation treatment to that area can stop those cells from growing. This makes it hard for tissue to repair itself. As cells die and are not replaced, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045692/" class="def">gastrointestinal</a> problems occur over the next few days and weeks. </p><p id="CDR0000062834__224">Doctors are studying whether the order that radiation therapy, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a> are given affects how severe the enteritis will be.<div class="milestone-end"></div></p></div><div id="CDR0000062834__110"><h3>Symptoms may begin during radiation therapy or months to years later.</h3><p id="CDR0000062834__183">Radiation enteritis may be <i><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045585/" class="def">acute</a></i> or <i><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045641/" class="def">chronic</a></i>:</p><ul id="CDR0000062834__184"><li class="half_rhythm"><div><i>Acute</i> radiation enteritis occurs during radiation therapy and may last up to 8 to 12 weeks after treatment stops.</div></li><li class="half_rhythm"><div><i>Chronic</i> radiation enteritis may appear months to years after radiation therapy ends, or it may begin as acute enteritis and keep coming back.</div></li></ul></div><div id="CDR0000062834__186"><h3>The total dose of radiation and other factors affect the risk of radiation enteritis.</h3><p id="CDR0000062834__112">Only 5% to 15% of patients treated with radiation to the abdomen will have chronic problems. The amount of time the enteritis lasts and how severe it is depend on the following:</p><ul id="CDR0000062834__113"><li class="half_rhythm"><div>The total dose of radiation received.
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</div></li><li class="half_rhythm"><div>The amount of normal intestine treated.
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</div></li><li class="half_rhythm"><div>The tumor size and how much it has spread.
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</div></li><li class="half_rhythm"><div>If chemotherapy was given at the same time as the radiation therapy.
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</div></li><li class="half_rhythm"><div>If <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046350/" class="def">radiation implants</a> were used.
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</div></li><li class="half_rhythm"><div>If the patient has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000458091/" class="def">high blood pressure</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044911/" class="def">diabetes</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000658027/" class="def">pelvic inflammatory disease</a>, or poor <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044698/" class="def">nutrition</a>.</div></li><li class="half_rhythm"><div>If the patient has had surgery to the abdomen or pelvis.</div></li></ul></div><div id="CDR0000062834__107"><h3>Acute and chronic enteritis have symptoms that are a lot alike.</h3><p id="CDR0000062834__109">Patients with acute enteritis may have the following <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a>:
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</p><ul id="CDR0000062834__130"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390302/" class="def">Nausea</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390324/" class="def">Vomiting</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046684/" class="def">Abdominal</a> cramps.
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</div></li><li class="half_rhythm"><div>Frequent urges to have a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651179/" class="def">bowel movement</a>.
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044083/" class="def">Rectal</a> pain, bleeding, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046274/" class="def">mucus</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046605/" class="def">stool</a>.
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</div></li><li class="half_rhythm"><div>Watery <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000306496/" class="def">diarrhea</a>.</div></li><li class="half_rhythm"><div>Feeling very tired.</div></li></ul><p id="CDR0000062834__180">Symptoms of acute enteritis usually go away 2 to 3 weeks after treatment ends.</p><p id="CDR0000062834__134">Symptoms of chronic enteritis usually appear 6 to 18 months after radiation therapy ends. It can be hard to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a>. The doctor will first check to see if the symptoms are being caused by a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">recurrent tumor</a> in the small intestine. The doctor will also need to know the patient's full history of radiation treatments.
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</p><p id="CDR0000062834__181">Patients with chronic enteritis may have the following signs and symptoms:</p><ul id="CDR0000062834__135"><li class="half_rhythm"><div>Abdominal cramps.
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</div></li><li class="half_rhythm"><div>Bloody diarrhea.
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</div></li><li class="half_rhythm"><div>Frequent urges to have a bowel movement.
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</div></li><li class="half_rhythm"><div>Greasy and fatty stools.
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</div></li><li class="half_rhythm"><div>Weight loss.
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</div></li><li class="half_rhythm"><div>Nausea.
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</div></li></ul></div><div id="CDR0000062834__40"><h3>Assessment of radiation enteritis includes a physical exam and questions for the patient. </h3><p id="CDR0000062834__42">Patients will be given a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270871/" class="def">physical exam</a> and be asked questions about the following:</p><ul id="CDR0000062834__138"><li class="half_rhythm"><div>Usual pattern of bowel movements.
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</div></li><li class="half_rhythm"><div>Pattern of diarrhea:<dl id="CDR0000062834__201" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">When it started.</p></dd><dt>-</dt><dd><p class="no_top_margin">How long it has lasted.</p></dd><dt>-</dt><dd><p class="no_top_margin">How often it occurs.</p></dd><dt>-</dt><dd><p class="no_top_margin">Amount and type of stools.</p></dd><dt>-</dt><dd><p class="no_top_margin">Other symptoms with the diarrhea (such as gas, cramping, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476585/" class="def">bloating</a>, urgency, bleeding, and rectal soreness).</p></dd></dl>
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</div></li><li class="half_rhythm"><div>Nutrition health: <dl id="CDR0000062834__202" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">Height and weight.</p></dd><dt>-</dt><dd><p class="no_top_margin">Usual eating habits.</p></dd><dt>-</dt><dd><p class="no_top_margin">Changes in eating habits.</p></dd><dt>-</dt><dd><p class="no_top_margin">Amount of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046401/" class="def">fiber</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044660/" class="def">diet</a>.</p></dd><dt>-</dt><dd><p class="no_top_margin">Signs of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044659/" class="def">dehydration</a> (such as poor skin tone, increased weakness, or feeling very tired).</p></dd></dl></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000450122/" class="def">Stress</a> levels and ability to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454700/" class="def">cope</a>.</div></li><li class="half_rhythm"><div>Changes in lifestyle caused by the enteritis.</div></li></ul></div><div id="CDR0000062834__114"><h3>Treatment depends on whether the radiation enteritis is acute or chronic. </h3><div id="CDR0000062834__139"><h4>Acute radiation enteritis </h4><p id="CDR0000062834__153">Treatment of acute enteritis includes treating the symptoms. The symptoms usually get better with treatment, but if symptoms get worse, then cancer treatment may have to be stopped for a while.
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</p><p id="CDR0000062834__154">Treatment of acute radiation enteritis may include the following: </p><ul id="CDR0000062834__175"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482419/" class="def">Medicines</a> to stop diarrhea.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045054/" class="def">Opioids</a> to relieve pain.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000613764/" class="def">Steroid</a> foams to relieve rectal inflammation. </div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046704/" class="def">Pancreatic enzyme</a> replacement for patients who have <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044521/" class="def">pancreatic cancer</a>. A decrease in pancreatic enzymes can cause diarrhea. </div></li><li class="half_rhythm"><div>Diet changes. Intestines damaged by radiation therapy may not make enough of certain <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046081/" class="def">enzymes</a> needed for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463707/" class="def">digestion</a>, especially <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476616/" class="def">lactase</a>. Lactase is needed to digest <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044686/" class="def">lactose</a>, which is found in milk and milk products. A lactose-free, low-fat, and low-fiber diet may help to control symptoms of acute enteritis.<dl id="CDR0000062834__142" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">Foods to avoid:<ul id="CDR0000062834__143"><li class="half_rhythm"><div>Milk and milk products, except buttermilk, yogurt, and lactose-free milkshake <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000441266/" class="def">supplements</a>, such as Ensure.
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</div></li><li class="half_rhythm"><div>Whole-bran bread and cereal.
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</div></li><li class="half_rhythm"><div>Nuts, seeds, and coconut.
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</div></li><li class="half_rhythm"><div>Fried, greasy, or fatty foods.</div></li><li class="half_rhythm"><div>Fresh and dried fruit and some fruit juices (such as prune juice).</div></li><li class="half_rhythm"><div>Raw vegetables.</div></li><li class="half_rhythm"><div>Rich pastries.</div></li><li class="half_rhythm"><div>Popcorn, potato chips, and pretzels.</div></li><li class="half_rhythm"><div>Strong spices and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463714/" class="def">herbs</a>.</div></li><li class="half_rhythm"><div>Chocolate, coffee, tea, and soft drinks with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454809/" class="def">caffeine</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463134/" class="def">Alcohol</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000439432/" class="def">tobacco</a>.</div></li></ul></p></dd><dt>-</dt><dd><p class="no_top_margin">Foods to choose:<ul id="CDR0000062834__144"><li class="half_rhythm"><div>Fish, poultry, and meat that are broiled or roasted.</div></li><li class="half_rhythm"><div>Bananas.</div></li><li class="half_rhythm"><div>Applesauce and peeled apples.</div></li><li class="half_rhythm"><div>Apple and grape juices.</div></li><li class="half_rhythm"><div>White bread and toast.</div></li><li class="half_rhythm"><div>Macaroni and noodles.</div></li><li class="half_rhythm"><div>Baked, boiled, or mashed potatoes.</div></li><li class="half_rhythm"><div>Cooked vegetables that are mild, such as asparagus tips, green and waxed beans, carrots, spinach, and squash.
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</div></li><li class="half_rhythm"><div>Mild processed cheese. Processed cheese may not cause problems because the lactose is removed when it is made.</div></li><li class="half_rhythm"><div>Buttermilk, yogurt, and lactose-free milkshake supplements, such as Ensure.</div></li><li class="half_rhythm"><div>Eggs.</div></li><li class="half_rhythm"><div>Smooth peanut butter. </div></li></ul></p></dd><dt>-</dt><dd><p class="no_top_margin">Helpful hints: <ul id="CDR0000062834__145"><li class="half_rhythm"><div>Eat food at room temperature.
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</div></li><li class="half_rhythm"><div>Drink about 12 eight-<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000330174/" class="def">ounce</a> glasses of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044669/" class="def">fluid</a> a day.
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</div></li><li class="half_rhythm"><div>Let sodas lose their fizz before drinking them.
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</div></li><li class="half_rhythm"><div>Add nutmeg to food. This helps slow down movement of digested food in the intestines.
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</div></li><li class="half_rhythm"><div>Start a low-fiber diet on the first day of radiation therapy.</div></li></ul></p></dd></dl></div></li></ul></div><div id="CDR0000062834__146"><h4>Chronic radiation enteritis </h4><p id="CDR0000062834__148">Treatment of chronic radiation enteritis may include the following:</p><ul id="CDR0000062834__203"><li class="half_rhythm"><div>Same treatments as for <a href="#CDR0000062834__139">acute radiation enteritis symptoms</a>.</div></li><li class="half_rhythm"><div>Surgery. Few patients need surgery to control their symptoms.
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Two types of surgery may be used:
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<dl id="CDR0000062834__150" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044046/" class="def">Intestinal</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046498/" class="def">bypass</a>: A procedure in which the doctor creates a new pathway for the flow of intestinal contents around the damaged tissue.</p></dd><dt>-</dt><dd><p class="no_top_margin">Total intestinal <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046565/" class="def">resection</a>: Surgery to completely remove the intestines. </p></dd></dl>Doctors look at the patient's general health and the amount of damaged tissue before deciding if surgery will be needed. Healing after surgery is often slow and long-term <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390298/" class="def">tubefeeding</a> may be needed. Even after surgery, many patients still have symptoms.
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</div></li></ul></div></div></div><div id="CDR0000062834__234"><h2 id="_CDR0000062834__234_">Current Clinical Trials</h2><p id="CDR0000062834__TrialSearch_234_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000062834__AboutThis_1"><h2 id="_CDR0000062834__AboutThis_1_">About This PDQ Summary</h2><div id="CDR0000062834__AboutThis_2"><h3>About PDQ</h3><p id="CDR0000062834__AboutThis_3">Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in <a href="https://www.cancer.gov/espanol/publicaciones/pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Spanish</a>.</p><p id="CDR0000062834__AboutThis_4">PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.</p></div><div id="CDR0000062834__AboutThis_5"><h3>Purpose of This Summary</h3><p id="CDR0000062834__AboutThis_6">This PDQ cancer information summary has current information about the causes and treatment of gastrointestinal complications, including constipation, impaction, bowel obstruction, diarrhea, and radiation enteritis. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p></div><div id="CDR0000062834__AboutThis_7"><h3>Reviewers and Updates</h3><p id="CDR0000062834__AboutThis_8">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change.
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</p><p id="CDR0000062834__AboutThis_9">The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the <a href="https://www.cancer.gov/publications/pdq/editorial-boards/supportive-care" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ Supportive and Palliative Care Editorial Board</a>.
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</p></div><div id="CDR0000062834__AboutThis_10"><h3>Clinical Trial Information</h3><p id="CDR0000062834__AboutThis_11">A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
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</p><p id="CDR0000062834__AboutThis_12">Clinical trials can be found online at <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI's website</a>. For more information, call the <a href="https://www.cancer.gov/contact/contact-center" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Cancer Information Service</a> (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237).
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</p></div><div id="CDR0000062834__AboutThis_13"><h3>Permission to Use This Summary</h3><p id="CDR0000062834__AboutThis_14">PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”
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</p><p id="CDR0000062834__AboutThis_15">The best way to cite this PDQ summary is:</p><p id="CDR0000062834__AboutThis_21">PDQ® Supportive and Palliative Care Editorial Board. PDQ Gastrointestinal Complications. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: <a href="https://www.cancer.gov/about-cancer/treatment/side-effects/constipation/GI-complications-pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www.cancer.gov/about-cancer/treatment/side-effects/constipation/GI-complications-pdq</a>. Accessed <MM/DD/YYYY>. [PMID: 26389438]</p><p id="CDR0000062834__AboutThis_16">Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in <a href="https://visualsonline.cancer.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Visuals Online</a>. Visuals Online is a collection of more than 3,000 scientific images.
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</p></div><div id="CDR0000062834__AboutThis_17"><h3>Disclaimer</h3><p id="CDR0000062834__AboutThis_18">The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the <a href="https://www.cancer.gov/about-cancer/managing-care" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Managing Cancer Care</a> page.</p></div><div id="CDR0000062834__AboutThis_19"><h3>Contact Us</h3><p id="CDR0000062834__AboutThis_20">More information about contacting us or receiving help with the Cancer.gov website can be found on our <a href="https://www.cancer.gov/contact" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Contact Us for Help</a> page. Questions can also be submitted to Cancer.gov through the website’s <a href="https://www.cancer.gov/contact/email-us" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">E-mail Us</a>.</p></div></div></div></div>
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<div class="post-content"><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a></div><div class="small"><span class="label">Bookshelf ID: NBK66002</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/26389438" title="PubMed record of this page" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">26389438</a></span></div></div></div>
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<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK66002.4/?report=reader">PubReader</a></li><li><a href="/books/NBK66002.4/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK66002" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK66002" style="display:none" title="Cite this Page"><div class="bk_tt">PDQ Supportive and Palliative Care Editorial Board. Gastrointestinal Complications (PDQ®): Patient Version. 2019 Mar 7. In: PDQ Cancer Information Summaries [Internet]. 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