GASTRO-INTESTINAL PROBLEMS

This page is part of the PanCare PLAIN summaries about late effects and recommendations for long-term follow-up care for survivors of childhood, adolescent, and young adult cancer. Click here, for more information on the PLAIN summaries.

Gastro-intestinal problems

When we swallow our food, it passes through the food pipe (oesophagus) and into the stomach. Here the food is broken down into smaller bits. The food then moves to the bowels (intestines), where the water and nutrients from the food are absorbed. What is left is stool, which is stored in the rectum until you poo. All the organs that food travels through make up the gastro-intestinal tract.

Sometimes problems can occur with the gastro-intestinal tract. Gastro-intestinal problems include:

  • Obstruction, where a part of the gastro-intestinal tract narrows. This makes it more difficult for food to pass through.
  • Gallstones, which are small stones that form in the gallbladder. If the stones become too big, they can obstruct the opening of the gallbladder.
  • Chronic inflammation, which is caused by an infection of the gastro-intestinal tract or an underlying disease.
  • A gastro-intestinal fistula. This is an abnormal opening or hole which allows fluids to seep through from the bowels to another part of the body.
  • Malabsorption, where not enough nutrients are absorbed from the food.
  • Nerve damage, which can cause stool to leak from the anus.

Am I at higher risk of gastro-intestinal problems?

Anyone, including people who have never had cancer treatment, may develop gastro-intestinal problems. However, there are some cancer treatments that may increase the risk of having gastro-intestinal problems later in life. The problems that can occur depend on the type of cancer treatment received.

The following treatments can increase the risk of gastro-intestinal problems:

  • Radiotherapy to the gastro-intestinal tract or an area that includes the gastro-intestinal tract can cause problems in the area that was treated.
  • Surgery to the oesophagus or abdomen can cause problems in the area that was operated on.
  • Stem cell transplantation can cause problems when graft-versus-host disease (GvHD) occurs in the gastro-intestinal tract.

You can find out if you have received any of these treatments by looking at your treatment summary. If you do not have a treatment summary or if you have any questions, do contact your treating hospital.

If you experience gastro-intestinal problems, it does not always mean that it was caused by your cancer treatment. Gastro-intestinal problems may have other causes.

What are the symptoms and signs of gastro-intestinal problems?

There are symptoms and signs that can tell you if you might have gastro-intestinal problems. You might not have these symptoms and signs at the moment, but it is important to be aware of them in case they may develop in the future.

These symptoms may suggest that you have gastro-intestinal problems:

  • Pain in the abdomen (belly pain)
  • Unexplained weight loss
  • Difficulty swallowing
  • Feeling bloated, nauseous and/or vomiting
  • The stool is abnormal or different from usual for a longer period of time
  • Stool leaking from the anus (incontinence)
  • Yellow coloured eyes and/or skin. This is also known as icterus or jaundice.

Usually gastro-intestinal problems are temporary and the problems will usually go away on their own. However, if you experience any of these symptoms or signs for a longer time period and/or if you feel very unwell, please contact your general practitioner or follow-up care specialist.

What happens if I have gastro-intestinal problems?

If you have gastro-intestinal problems, your general practitioner or follow-up care specialist will probably refer you to a specialist. Depending on the symptoms and/or signs you experience, you may be referred to a:

  • Gastrointestinal or colorectal surgeon (surgeon specialised in the digestive system)
  • Gastro-enterologist (physician specialised in the digestive system)

The specialist may do further testing and discuss treatment different options with you.

What else can I do?

Experiencing gastro-intestinal problems can be difficult. Talking to friends and family can be helpful as well as specialist counselling and/or contact with support groups, such as patient organisations. For more information on taking care of your mental health, please read: Mental health problems.

To lower the risk of gastro-intestinal problems, it is very important to live a healthy lifestyle. Taking care of your mental health may be beneficial; even small changes to your lifestyle can have a positive impact on both your physical and mental health. For more information on taking up a healthier lifestyle, please read: Health promotion.

It is important that you are aware of the possibility of developing gastro-intestinal problems and that you know the symptoms and signs. If you have any further questions or the information in this brochure concerns you, please contact your general practitioner or follow-up care specialist.

Where can I find more information?

You may find more information about gastro-intestinal problems online. However, it is important to be aware that this information is not always up to date or accurate.

Some sources of further information are:

  • NHS: Here you can find more information about digestive health
  • Together: Here you can find more information about digestive problems after cancer or its treatment

On this website, you can also find more information related to this topic:

Please note

This PLAIN summary is based on the PanCareFollowUp guideline about “Gastro-intestinal problems” [1], which is based on the consensus of different national guidelines.

While the PanCare PLAIN information group strives to provide accurate and complete information that is up-to-date as of the date of publication, you can check with your general practitioner or follow-up care specialist if this summary reflects the most up-to-date information available and whether it is relevant for you.

Please do not rely solely on this information. It is best to also seek the advice of a qualified medical practitioner if you have questions regarding a specific medical condition, disease, diagnosis or symptom.

No warranty or representation, expressed or implied, is made concerning the accuracy, reliability, completeness, relevance, or timeliness of this information. PanCare has produced the English version and PanCare is not responsible for the translated versions of this summary.

The PanCare materials are free to use for anyone aiming to inform about late effects and long-term survivorship care. However, no financial advantage may be achieved. All communication should reference PanCare and link to the PanCare website.

[1] van Kalsbeek, R. et al. (2021) European PANCAREFOLLOWUP recommendations for surveillance of late effects of childhood, adolescent, and Young Adult Cancer, European journal of cancer. Available at: https://www.ejcancer.com/article/S0959-8049(21)00368-3/fulltext.