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Gastro-intestinal problems

Anyone, even people who have never had cancer, can develop gastrointestinal problems. However, some cancer treatments can increase the risk. It is important that you recognize and understand symptoms and signs that may indicate gastrointestinal problems.

What are gastrointestinal problems?

Food that you swallow passes through the esophagus to the stomach. There it is broken down into small pieces. Then it enters the intestines, which absorb fluids and nutrients from the food. What remains is stool that you excrete. The organs through which the food passes together form the gastrointestinal tract.

Sometimes problems arise in the gastrointestinal tract, such as:

  • Intestinal blockage: food has difficulty passing through

  • Gallstones: stones that block the opening of the gallbladder if they become large

  • Chronic inflammation caused by an infection or disease

  • Fistula: an opening in the intestine through which fluid can leak

  • Malabsorption: the intestines do not absorb enough nutrients from food

  • Nerve damage: stool leaks from the anus

Do I have an increased risk of gastrointestinal problems?

Everyone, including people who have never had cancer, can experience gastrointestinal problems. But some cancer treatments can increase the risk.

The following treatments can increase the risk of gastrointestinal problems:

  • Radiation to the gastrointestinal tract or to an area where the gastrointestinal tract is located

  • Surgery on the esophagus or abdomen

  • Chemotherapy: vincristine

  • Allogeneic stem cell transplantation (from a donor) with graft-versus-host disease affecting the gastrointestinal tract

You can check your treatment summary to see if you have had one or more of these treatments. If you do not have a summary, you can contact the LATER clinic or the hospital where you were treated. Gastrointestinal problems are not always caused by treatment. Other causes may also exist.

What are the symptoms and signs of gastrointestinal problems?

Certain symptoms and signs may indicate gastrointestinal problems. Even if you do not currently have these symptoms and signs, it is important to recognize them in case you experience them in the future.

The following symptoms and signs may indicate gastrointestinal problems:

  • Abdominal pain

  • Unexplained weight loss

  • Difficulty swallowing

  • Bloating, nausea, and/or vomiting

  • Abnormal or long-term changes in stool

  • Unintended loss of stool (incontinence)

  • Yellow eyes and/or skin (jaundice)

Gastrointestinal problems are usually temporary and resolve on their own. If you recognize any of these symptoms or signs, contact your GP or LATER physician.

What tests are needed and when if I am at increased risk?

If you are at increased risk of gastrointestinal problems, regular LATER clinic visits are sufficient. Attention will be paid to this during the detailed medical history.

What happens if I have gastrointestinal problems?

If you have gastrointestinal problems, your GP or LATER physician will likely refer you to a:

  • Gastroenterologist. This specialist will discuss the treatment options with you.

What else can I do?

Living with (an increased risk of) gastrointestinal problems can be challenging. Talking with friends and family can help. Connecting with people in similar situations can also be helpful, for example through a patient organization such as VOX, part of the Dutch Childhood Cancer Organization.

Take good care of yourself. A healthy lifestyle can reduce the risk of gastrointestinal problems. Also pay attention to your mental health. Small changes can have a positive impact on your physical and mental well-being. It is important that you know that gastrointestinal problems can occur after cancer and that you recognize the symptoms and signs. If you have any questions or concerns after reading this information, contact your GP or LATER physician.

Where can I find more information?

  • Healthy lifestyle

  • Mental health

  • Liver problems

  • Second cancer: colon cancer

Disclaimer: This information is based on the PLAIN language summary of the guideline below, created by the PanCare PLAIN Information Group, and has been adapted where necessary to the Dutch LATER guideline. Do not rely solely on this information for symptoms and signs; consult your GP, LATER physician, or specialist.