Treatment-resistant severe capecitabine-induced diarrhoea resolved with oral budesonide

John Shumar; Zachary Junga; Jeptha T Johnson; Lawrence Goldkind

doi:10.1136/bcr-2019-231544

Treatment-resistant severe capecitabine-induced diarrhoea resolved with oral budesonide

BMJ Case Rep. 2019 Dec 1;12(11):e231544. doi: 10.1136/bcr-2019-231544.

Authors

John Shumar¹, Zachary Junga², Jeptha T Johnson³, Lawrence Goldkind²

Affiliations

¹ Internal Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland, USA John.n.shumar.mil@mail.mil.
² Gastroenterology, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
³ Pathology and Laboratory Services, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.

Abstract

Chemotherapy-induced diarrhoea (CID) is a risk of antineoplastic regimens, often associated with 5-fluorouracil (5-FU), irinotecan and capecitabine. Current treatment guidelines for CID include the use of loperamide and octreotide but do not account for other therapies, including budesonide. Small case reports have shown benefit with budesonide in CID secondary to 5-FU and irinotecan, but there is no literature base addressing budesonide use in CID secondary to capecitabine. We describe a case of a patient with severe capecitabine-induced diarrhoea that was refractory to guideline based therapy but resolved with the use of budesonide.

Keywords: colon cancer; drugs: gastrointestinal system; gastroenterology; gastrointestinal system; pathology.

Publication types

Case Reports

MeSH terms

Adenocarcinoma / drug therapy
Aged, 80 and over
Antimetabolites, Antineoplastic / adverse effects*
Budesonide / therapeutic use*
Capecitabine / adverse effects*
Diarrhea / chemically induced
Diarrhea / drug therapy*
Female
Glucocorticoids / therapeutic use*
Humans
Rectal Neoplasms / drug therapy

Substances

Antimetabolites, Antineoplastic
Glucocorticoids
Budesonide
Capecitabine