Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Persistent Diarrhea While Treating Colorectal Cancer With Chemotheraphy?
Question: My mom is undergoing Chemotheraphy using drugs catecitabine (14 day tablets with 7 days rest) - 21 day cycle. On 11th day, she had severe sideeffects like nausea and diarrhea. So the doctor asked us to stop the chemo tablets, and she is having tablets to stop diarrhea by taking Eldoper . But its more than a week now and she still has diarrhea . She is become very weak . she was admitted for fluids till yesterday for 5 days .We came back home , but still she has diarrhea. we are really worried. She looks weak. its more than 10 days now
Her CEA taken day before yesterday is 21.1 last month it was 42.8. I have attached the reports of complete Blood count, urea / creatinine
Her CEA taken day before yesterday is 21.1 last month it was 42.8. I have attached the reports of complete Blood count, urea / creatinine
Brief Answer:
Please provide further information
Detailed Answer:
Hello, Sir.
I can certainly understand your concerns.
I would like to know for which cancer is she receiving Chemotherapy?
And what is its stage?
If possible attach any Diagnostic reports?
Once I receive your answers I will guide you appropriately.
Thank you
Please provide further information
Detailed Answer:
Hello, Sir.
I can certainly understand your concerns.
I would like to know for which cancer is she receiving Chemotherapy?
And what is its stage?
If possible attach any Diagnostic reports?
Once I receive your answers I will guide you appropriately.
Thank you
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks Doctor for going through my query
Below is the detailed history..
My Mom is 56 years old , 74 kg, she was diagnosed with Colo-Rectal cancer Stage IV in Aug-2011. Her Sugar and BP levels are normal. She underwent Chemotherapy through IV - 5-fluorouracil (5-FU) using port a XXXXXXX The 6 cycles of Chemo completed in April 2012 (Tab- capecitabine).
Since January the next year ie,2013 she had post menopause bleeding and on diagnosis, we were informed that there was recurrence in the pelvic region.Our doctor advised us to have a surgery done to remove the uterus and then go in for chemotherapy., as suggested post laparotomy she had a palliative chemotherapy using drugs - IRINOTECAN & AVASTIN (6+2 cycles).
All through the above treatments she was positive and gradually but steadily got back to normal like any other healthy individual.We have been continuously following up on CEA and Scans since then.
The latest ie., December 2015's cea report XXXXXXX to double the value (42.8) she had in November (23.2) . So our doctor asked us to have a PET Scan. We immediately had a PET scan and the scan revelead, there are tumor spots on her pelvis and anterior layer of Abdomen. So he further advised us to go for chemo's. The chemo cycle 1 again began on XXXXXXX 7th 2016, using drugs catecitabine (14 day tablets with 7 days rest) - 21 day cycle. On 11th day, she had severe sideeffects like nausea and diarrhea. Our doctor asked us to stop the chemo tablets, and she is having tablets to stop diarrhea by taking Eldoper/emeset . But its more than a week now and she still has diarrhea . She is become very weak . she was admitted for fluids till yesterday for 5 days .We came back home , but still she has diarrhea. we are really worried. She looks weak. its more than 10 days now. Please let us know what diet to go about? How to control the severe side effects at this point?
Thanks much in Advance
Below is the detailed history..
My Mom is 56 years old , 74 kg, she was diagnosed with Colo-Rectal cancer Stage IV in Aug-2011. Her Sugar and BP levels are normal. She underwent Chemotherapy through IV - 5-fluorouracil (5-FU) using port a XXXXXXX The 6 cycles of Chemo completed in April 2012 (Tab- capecitabine).
Since January the next year ie,2013 she had post menopause bleeding and on diagnosis, we were informed that there was recurrence in the pelvic region.Our doctor advised us to have a surgery done to remove the uterus and then go in for chemotherapy., as suggested post laparotomy she had a palliative chemotherapy using drugs - IRINOTECAN & AVASTIN (6+2 cycles).
All through the above treatments she was positive and gradually but steadily got back to normal like any other healthy individual.We have been continuously following up on CEA and Scans since then.
The latest ie., December 2015's cea report XXXXXXX to double the value (42.8) she had in November (23.2) . So our doctor asked us to have a PET Scan. We immediately had a PET scan and the scan revelead, there are tumor spots on her pelvis and anterior layer of Abdomen. So he further advised us to go for chemo's. The chemo cycle 1 again began on XXXXXXX 7th 2016, using drugs catecitabine (14 day tablets with 7 days rest) - 21 day cycle. On 11th day, she had severe sideeffects like nausea and diarrhea. Our doctor asked us to stop the chemo tablets, and she is having tablets to stop diarrhea by taking Eldoper/emeset . But its more than a week now and she still has diarrhea . She is become very weak . she was admitted for fluids till yesterday for 5 days .We came back home , but still she has diarrhea. we are really worried. She looks weak. its more than 10 days now. Please let us know what diet to go about? How to control the severe side effects at this point?
Thanks much in Advance
Brief Answer:
Possible CID stage 3/4.
Detailed Answer:
Hello, Madam
I can certainly understand your concerns.
I apologise for the delayed response owing to my work schedule.
As per the history suggested, this could likely to be Complicated CID(chemotherapy induced diarhoea, stage 3 - 4).
Dietary modifications such as eliminating all lactose-containing products, and high osmolar dietary supplements may help decrease CID.
Sorbitol-containing products, such as sugar-free gum and candy, should be eliminated, as they can cause diarrhea
Hydrating with 8-10 glasses of clear liquids per day, implementing the BRAT diet (Bananas, rice, applesauce, toast), and eating small frequent meals will be helpful.
Oral rehydration with fluids that contain water, sugar and salt will help prevent hyponatremia.
Examples of such fluids are sports drinks, broth, gelatin and decaffeinated /decarbonated soft drinks .
There seems to be no response to ELDOPER and it's not wise to continue it .
At this point, 2nd line antidiarrheals like Octreotide have to be started after excluding infection.
At this point, the patient should be assessed by a practitioner and a complete work-up should be performed, including stool cultures for infection and blood work to evaluate for neutropenia and electrolyte imbalances.
Starting Octreotide @ 150 mcg via subcutaneous or IV route should be the most logical step. at the moment.Based on reports of stool culture antibiotics may be started to prevent or control infection.
Aggressive and timely management will improve her condition.
Please check with your physician if he shares my view and if can prescribe them to her.
Post your further queries if any.
Thank you
Possible CID stage 3/4.
Detailed Answer:
Hello, Madam
I can certainly understand your concerns.
I apologise for the delayed response owing to my work schedule.
As per the history suggested, this could likely to be Complicated CID(chemotherapy induced diarhoea, stage 3 - 4).
Dietary modifications such as eliminating all lactose-containing products, and high osmolar dietary supplements may help decrease CID.
Sorbitol-containing products, such as sugar-free gum and candy, should be eliminated, as they can cause diarrhea
Hydrating with 8-10 glasses of clear liquids per day, implementing the BRAT diet (Bananas, rice, applesauce, toast), and eating small frequent meals will be helpful.
Oral rehydration with fluids that contain water, sugar and salt will help prevent hyponatremia.
Examples of such fluids are sports drinks, broth, gelatin and decaffeinated /decarbonated soft drinks .
There seems to be no response to ELDOPER and it's not wise to continue it .
At this point, 2nd line antidiarrheals like Octreotide have to be started after excluding infection.
At this point, the patient should be assessed by a practitioner and a complete work-up should be performed, including stool cultures for infection and blood work to evaluate for neutropenia and electrolyte imbalances.
Starting Octreotide @ 150 mcg via subcutaneous or IV route should be the most logical step. at the moment.Based on reports of stool culture antibiotics may be started to prevent or control infection.
Aggressive and timely management will improve her condition.
Please check with your physician if he shares my view and if can prescribe them to her.
Post your further queries if any.
Thank you
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
