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Table 2. Possible Contributions to Diarrhea in Cancer
Cancer-related [5,18] |
Carcinoid syndrome |
Colon cancer |
Lymphoma |
Medullary carcinoma of the thyroid |
Pancreatic cancer, particularly islet cell tumors (Zollinger-Ellison syndrome) |
Pheochromocytoma |
Surgery- or procedure-related [14] |
Celiac plexus block |
Cholecystectomy, esophagogastrectomy |
Gastrectomy, pancreaticoduodenectomy (Whipple procedure) |
Intestinal resection (malabsorption due to short bowel syndrome) |
Vagotomy |
Chemotherapy-related [19,20] |
Capecitabine, cisplatin, cytosine arabinoside, cyclophosphamide, daunorubicin, docetaxel, doxorubicin, 5-fluorouracil, interferon, irinotecan, leucovorin, methotrexate, oxaliplatin, paclitaxel, topotecan |
Radiation therapy–related (refer to the Radiation Enteritis section of this summary) [21,22] |
Irradiation to the abdomen, para-aortics, lumbar, and pelvis |
Bone marrow transplantation–related [23] |
Conditioning chemotherapy, total-body irradiation, graft-versus-host disease after allogeneic bone marrow or peripheral blood stem cell transplants |
Drug adverse effects [5,18] |
Antibiotics, magnesium-containing antacids, antihypertensives, colchicine, digoxin, iron, lactulose, laxatives, methyldopa, metoclopramide, misoprostol, potassium supplements, propanolol, theophylline |
Concurrent disease [5,18] |
Diabetes, hyperthyroidism, inflammatory bowel disease (Crohn disease, diverticulitis, gastroenteritis, HIV/AIDS, ulcerative colitis), obstruction (tumor-related) |
Infection [24] |
Clostridium difficile, Clostridium perfringens, Bacillus cereus, Giardia lamblia, Cryptosporidium, Salmonella, Shigella, Campylobacter, Rotavirus
|
Fecal impaction [5,18] |
Constipation leading to obstruction |
Diet [5,18] |
Alcohol, milk, and dairy products (particularly in patients with lactose intolerance) |
Caffeine-containing products (coffee, tea, chocolate), specific fruit juices (prune juice, unfiltered apple juice, sauerkraut juice) |
High-fiber foods (raw fruits and vegetables, nuts, seeds, whole-grain products, dried legumes); high-fat foods (deep fat–fried foods, high-fat containing foods) |
Lactulose intolerance or food allergies |
Sorbitol-containing foods (candy and chewing gum); hot and spicy foods; gas-forming foods and beverages (cruciferous vegetables, dried legumes, melons, carbonated beverages) |
Psychological factors [18] |
Stress |
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