Book contents
- Frontmatter
- Contents
- Acknowledgments
- Contributor
- 1 Rationale for transplantation
- 2 Types of transplantation
- 3 Human leukocyte antigen matching in allogeneic transplantation
- 4 Stem cell source
- 5 Pretransplant evaluation and counseling of patient and donor
- 6 Conditioning regimens
- 7 Stem cell infusion
- 8 ABO compatibility
- 9 Engraftment
- 10 Preventative care
- 11 Transplant-related complications
- 12 Overview of acute and chronic graft-versus-host disease
- 13 Acute graft-versus-host disease and staging
- 14 Graft-versus-host disease prophylactic regimens
- 15 Treatment guidelines for acute graft-versus-host disease
- 16 Chronic graft-versus-host disease
- 17 Engraftment syndrome
- 18 Infectious disease
- 19 Graft rejection and failure
- 20 Gastrointestinal complications
- 21 Oral health in stem cell transplantation
- 22 Pulmonary complications
- 23 Veno-occlusive disease
- 24 Special transfusion-related situations
- 25 Cardiovascular complications
- 26 Neurologic complications
- 27 Cystitis
- 28 Donor lymphocyte infusion
- 29 Transplantation: regulation and accreditation
- Index
20 - Gastrointestinal complications
Published online by Cambridge University Press: 05 November 2013
- Frontmatter
- Contents
- Acknowledgments
- Contributor
- 1 Rationale for transplantation
- 2 Types of transplantation
- 3 Human leukocyte antigen matching in allogeneic transplantation
- 4 Stem cell source
- 5 Pretransplant evaluation and counseling of patient and donor
- 6 Conditioning regimens
- 7 Stem cell infusion
- 8 ABO compatibility
- 9 Engraftment
- 10 Preventative care
- 11 Transplant-related complications
- 12 Overview of acute and chronic graft-versus-host disease
- 13 Acute graft-versus-host disease and staging
- 14 Graft-versus-host disease prophylactic regimens
- 15 Treatment guidelines for acute graft-versus-host disease
- 16 Chronic graft-versus-host disease
- 17 Engraftment syndrome
- 18 Infectious disease
- 19 Graft rejection and failure
- 20 Gastrointestinal complications
- 21 Oral health in stem cell transplantation
- 22 Pulmonary complications
- 23 Veno-occlusive disease
- 24 Special transfusion-related situations
- 25 Cardiovascular complications
- 26 Neurologic complications
- 27 Cystitis
- 28 Donor lymphocyte infusion
- 29 Transplantation: regulation and accreditation
- Index
Summary
Nausea/Vomiting
Chemotherapy and/or radiationare typically emetogenic, and symptoms are expected early afterhematopoietic stem cell transplantation. Medications such as antibiotics,opioids, MMF, mepron, and others can also contribute to nausea and vomiting.Acute upper gastrointestinal (GI) graft-versus-host disease (GVHD) typicallymanifests as nausea and can only be reliably diagnosed by stomach biopsy.Infections with herpes simplex virus (HSV), cytomegalovirus (CMV),adenovirus, Helicobacter pylori, and fungus are commonoffenders and need to be treated specifically.
Pattern
Acute onset occurs within 24 hours of chemotherapy administration (peak at 4–6 h) and lasts for 24 to 48 hours. Usually responds to drug therapy.
Delayed onset occurs more than 24 hours after chemotherapy administration (peak at 2–3 days) and can last for several days. Variable response to drug therapy – commonly seen with cyclophosphamide, anthracyclines, and cisplatin.
Delayed after engraftment, usually associated with weight loss; may be GVHD.
Diagnostic testing
Upper endoscopy with biopsy may be useful to assess for either GVHD or infectious etiologies.
Management
It is preferable to prevent asmuch nausea and vomiting as possible since treatment of established nauseais more dii cult to manage. Moreover, prevention will decrease futureanticipatory, breakthrough, and delayed nausea/vomiting.
- Type
- Chapter
- Information
- Manual of Stem Cell and Bone Marrow Transplantation , pp. 124 - 129Publisher: Cambridge University PressPrint publication year: 2013