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What is the cause of abdominal pain with chemo treatments?

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Oncologist, Surgical
Practicing since : 1986
Answered : 59 Questions
I am on Xeloda, 1500mg 2X daily, two weeks on one off. Colon cancer, 10cm colectomy at the sigmoid colon, two 26 week chemo treatments. I have had at irregular times severe abdominal pain. Trips to the ER, morphine and one or two bags of saline help. X-Rays and CT scans show no blockage in the colon. I have tried more then less fiber, no detectable difference. Nothing to tie one occurrence with the next. Ideas?
Posted Wed, 5 Mar 2014 in Cancer
Answered by Dr. K. Harish 34 minutes later
Brief Answer: Probably post operative adhesions Detailed Answer: There could be two issues. One is post surgical that is surgery related. The second could be drug (chemotherapy) related. The possibility of surgical procedure related are higher. One common cause could be post operative adhesions. After surgery, parts of intestine, omentum (apron like loose tissue covering the entire intestines) and some times the surgical scar or other areas of abdominal wall can get attached to each other. This is called adhesions. These usually settle down over a period of time. Rarely they can give rise to physical obstruction. From your description there is NO obstruction. These adhesions can give rise to colicky abdominal pain. This probably is the cause and should settle down. Very rarely this could continue for long periods of time. I am not sure if circular staplers were used for anastomosis (suturing the cut intestines). This could cause a small narrowing at the fusion area and could cause occasional pain Drug induced infection or colitis causing pain is remote based on your symptom description. One other area you could check is the use of antibiotics. These would have altered your colonic bacterial flora during surgery. An outside chance, but check with your doctor on this and if probiotics could help. Remember this is a very slim chance of being correct.
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