TY - JOUR
T1 - Clinical evaluation and treatment of chronic bowel symptoms following cancer in the colon and pelvic organs
AU - Larsen, Helene Mathilde
AU - Borre, Mette
AU - Christensen, Peter
AU - Mohr Drewes, Asbjørn
AU - Laurberg, Søren
AU - Krogh, Klaus
AU - Fassov, Janne
PY - 2019/5
Y1 - 2019/5
N2 - BACKGROUND: Chronic gastrointestinal symptoms are common among patients surviving surgery and/or radio-/chemotherapy for cancer in the pelvic organs. However, little is known about the pathophysiology behind symptoms or the effect of treatment. The aim of the present study was to present the results of clinical evaluation and treatment of patients with chronic bowel symptoms after treatment for cancer in the colon or pelvic organs.MATERIAL AND METHODS: All patients referred to our department of gastroenterology between May 2016 and June 2018 with chronic bowel symptoms after treatment for cancer in the colon or pelvic organs were prospectively evaluated.RESULTS: In total, 60 patients had been referred. The patients were treated for cancer in the right colon (n = 31), sigmoid colon (n = 1), rectum (n = 14), anal canal (n = 4), cervix uteri (n = 5), corpus uteri (n = 2), ovary (n = 2), and prostate (n = 1). The median time from cancer treatment to referral was 5.5 (range 1-36) years. Symptoms mainly included frequent bowel movements (65%), loose stools (87%), urgency for defecation (57%), and fecal incontinence (50%). A specific cause of bowel dysfunction was found in 48 (80%) of the patients and 21 (35%) had more than one cause of bowel symptoms. Bile acid malabsorption was present in 35 patients and small intestinal bacterial overgrowth was detected in 32. Treatment included bile acid sequestrants (n = 36), antibiotics (n = 33), loperamide (n = 21), and dietary intervention (n = 20). Major improvement in bowel symptoms was reported by 23 (38%) patients, while another 27 (45%) reported some improvement.CONCLUSION: Most patients with chronic bowel symptoms following cancer in the colon or pelvic organs will benefit from expert clinical evaluation and targeted treatment.
AB - BACKGROUND: Chronic gastrointestinal symptoms are common among patients surviving surgery and/or radio-/chemotherapy for cancer in the pelvic organs. However, little is known about the pathophysiology behind symptoms or the effect of treatment. The aim of the present study was to present the results of clinical evaluation and treatment of patients with chronic bowel symptoms after treatment for cancer in the colon or pelvic organs.MATERIAL AND METHODS: All patients referred to our department of gastroenterology between May 2016 and June 2018 with chronic bowel symptoms after treatment for cancer in the colon or pelvic organs were prospectively evaluated.RESULTS: In total, 60 patients had been referred. The patients were treated for cancer in the right colon (n = 31), sigmoid colon (n = 1), rectum (n = 14), anal canal (n = 4), cervix uteri (n = 5), corpus uteri (n = 2), ovary (n = 2), and prostate (n = 1). The median time from cancer treatment to referral was 5.5 (range 1-36) years. Symptoms mainly included frequent bowel movements (65%), loose stools (87%), urgency for defecation (57%), and fecal incontinence (50%). A specific cause of bowel dysfunction was found in 48 (80%) of the patients and 21 (35%) had more than one cause of bowel symptoms. Bile acid malabsorption was present in 35 patients and small intestinal bacterial overgrowth was detected in 32. Treatment included bile acid sequestrants (n = 36), antibiotics (n = 33), loperamide (n = 21), and dietary intervention (n = 20). Major improvement in bowel symptoms was reported by 23 (38%) patients, while another 27 (45%) reported some improvement.CONCLUSION: Most patients with chronic bowel symptoms following cancer in the colon or pelvic organs will benefit from expert clinical evaluation and targeted treatment.
KW - Adult
KW - Aged
KW - Anti-Bacterial Agents/therapeutic use
KW - Bile Acids and Salts/metabolism
KW - Cholestyramine Resin/therapeutic use
KW - Chronic Disease
KW - Colorectal Neoplasms/complications
KW - Diarrhea/etiology
KW - Fecal Incontinence/etiology
KW - Female
KW - Gastrointestinal Diseases/diet therapy
KW - Humans
KW - Male
KW - Middle Aged
KW - Ovarian Neoplasms/complications
KW - Prospective Studies
KW - Prostatic Neoplasms/complications
KW - Steatorrhea/etiology
KW - Treatment Outcome
KW - Uterine Neoplasms/complications
UR - http://www.scopus.com/inward/record.url?scp=85060779255&partnerID=8YFLogxK
U2 - 10.1080/0284186X.2018.1562211
DO - 10.1080/0284186X.2018.1562211
M3 - Journal article
C2 - 30698052
SN - 0284-186X
VL - 58
SP - 776
EP - 781
JO - Acta Oncologica
JF - Acta Oncologica
IS - 5
ER -