Chemotherapy induced diarrhea (CID) is a relatively common side effect of cancer treatment, occurring as often as 50-80% of the time in patients undergoing chemotherapy (Stein, Voigt & Jordan, 2010). The effects of CID are physically, and emotionally debilitating and can be life threatening. Chemotherapy is toxic and through some understanding, appears to affect the gastrointestinal tract to excrete fluid and electrolytes at an alarming rate. Physically, the patient undergoes volume depletion, loss of electrolytes, and renal insufficiency, which may lead to dehydration, coma or even death without vigorous intervention.
While certain treatment guidelines exist, the exact pathophysiology related to chemotherapy induced diarrhea …show more content…
L., Catalano, 1993). It is less expensive compared to octreotide and is taken orally (PO), which is convenient for patients being treated on an outpatient basis. In comparison, octreotide is given as an injection subcutaneously (SQ), intramuscularly (IM,) or via a continuous intravenous infusion (IV) (Cascinu et al.), it cannot be given in oral form. Octreotide is a somatostatin mimicking growth hormone inhibitor that is known to slow intestinal activity, like loperamide it inhibits gastrointestinal peristalsis. Loperamide slows motility by directly affecting the nerve endings, where octreotide in addition to slowing motility, increases absorption of gastrointestinal fluid such as electrolytes as well as decreasing secretion of insulin and glucagon (Geller, Gilmore, Dix, Topping, Davison, Holland, Wingard, …show more content…
Studies that used a grade 2 or higher as a measure of CID based on the National Cancer Institute’s (NCI) Common Terminology Criteria for Adverse Events (CTCAE) (NCI, 2006) were included in the review. All studies that reported results based on a less than 2 grade of diarrhea were not considered, as the NCI considers a grade of 1-2 to be mild, uncomplicated and without potentially dangerous symptoms including nausea, vomiting, dehydration, sepsis, neutropenia, decreased performance status, and bleeding (Richardson, & Dobish,