Investigation and management of:

gastrointestiNal problemS after canCer treatment A quick guide for health professionals Background Most cancer survivors will not have any long-term lower GI consequences of their cancer or its treatment. However, some will develop problems including chronic diarrhoea, faecal incontinence, urgency, pain, bleeding and excessive flatulence, particularly following pelvic radiotherapy and surgery[1]. For these people quality of life can be severely affected. Chronic GI symptoms often affect those who have been treated with pelvic radiotherapy for urological cancers (30 % have chronic GI symptoms affecting quality of life)[1], gynaecological cancers (40%) and colorectal cancers (up to 66%)[1]. These symptoms may arise as new symptoms several years after cancer treatment has ended. The content of this Quick Guide is based on ‘The Practical Management of the Gastrointestinal Symptoms of Pelvic Radiation Disease’[2], by Andreyev et al, (often referred to as the ‘bowel algorithm ’ found to be effective in the ORBIT study[3], a randomised controlled trial) which can be downloaded at: www.macmillan.org.uk/prdgastroguidance For further information, please refer to the British Society of Gastroenterology ‘Practice guidance on the management of acute and chronic gastrointestinal problems arising as a result of treatment for cancer’.[4] This guide is designed to be used systematically, by working throug