Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Jan;97(1):31-49.
doi: 10.1007/s00277-017-3183-7. Epub 2017 Nov 24.

Diagnosis and management of gastrointestinal complications in adult cancer patients: 2017 updated evidence-based guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO)

M Schmidt-Hieber  1 , J Bierwirth  2 , D Buchheidt  3 , O A Cornely  4   5   6 , M Hentrich  7 , G Maschmeyer  8 , E Schalk  9 , J J Vehreschild  4   5 , Maria J G T Vehreschild  10   11   12 ; AGIHO Working Group
Affiliations
Review

Diagnosis and management of gastrointestinal complications in adult cancer patients: 2017 updated evidence-based guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO)

M Schmidt-Hieber et al. Ann Hematol. 2018 Jan.

Abstract

Cancer patients frequently suffer from gastrointestinal complications. In this manuscript, we update our 2013 guideline on the diagnosis and management of gastrointestinal complications in adult cancer patients by the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO). An expert group was put together by the AGIHO to update the existing guideline. For each sub-topic, a literature search was performed in PubMed, Medline, and Cochrane databases, and strengths of recommendation and the quality of the published evidence for major therapeutic strategies were categorized using the 2015 European Society for Clinical Microbiology and Infectious Diseases (ESCMID) criteria. Final recommendations were approved by the AGIHO plenary conference. Recommendations were made with respect to non-infectious and infectious gastrointestinal complications. Strengths of recommendation and levels of evidence are presented. A multidisciplinary approach to the diagnosis and management of gastrointestinal complications in cancer patients is mandatory. Evidence-based recommendations are provided in this updated guideline.

Keywords: Abdominal complications; Cancer; Chemotherapy; Colitis; Diarrhea; Infection.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest

DB is a consultant to Gilead Sciences and Merck Sharp & Dohme/Merck, received research grants from Gilead Sciences and Pfizer, honoraria for lectures from Astellas, Gilead Sciences, Merck Sharp & Dohme/Merck, Pfizer, and TEVA and travel grants from Astellas, Merck Sharp & Dohme/Merck, and Pfizer.

OAC is supported by the German Federal Ministry of Research and Education (BMBF grant 01KN0706), has received research grants from Astellas Pharma, Bayer, Basilea, Genzyme, Gilead Sciences, Pfizer, Merck, Optimer, Schering-Plough, Vicuron, has worked as a consultant for Astellas Pharma, Basilea, F2G, Gilead Sciences, Pfizer, Merck, Mölnlycke Health Care, Nektar Schering-Plough, Zeneus, and served at the speakers’ bureau of Schering-Plough, Astellas Pharma, Gilead Sciences, Merck, Pfizer, SpePharm and United Medical.

MH has served at the speakers` bureau of MSD, Roche, Novartis, Gilead Sciences, Boehringer Ingelheim, has received travels grants from MSD, Roche, Novartis, Gilead Sciences, Pfizer, Janssen-Cilag, and has served as a consultant for Takeda Pharma.

GM has served as a consultant for Gilead Sciences, MSD, Pfizer, Essex (Schering-Plough), Novartis and Sanofi-Aventis and has been on the Speakers’ Bureau for Gilead Sciences, MSD, Pfizer and Cephalon.

ES has received travel grants from Essex/Schering-Plough, Gilead, Janssen-Cilag, Merck/MSD, Novartis, Pfizer, Roche and Shire.

JV has received grants from Schering-Plough and Astellas Pharma, worked as a consultant for Pfizer and Schering-Plough, and served at the speakers’ bureau of Astellas Pharma, Gilead Sciences, Schering-Plough, Merck and Pfizer.

MJGTV is a consultant to: Berlin Chemie, MSD/Merck and Astellas Pharma; has served at the speakers’ bureau of: Astellas Pharma, Basilea, Gilead Sciences, Merck/MSD, Organobalance and Pfizer; received research funding from: 3M, Astellas Pharma, DaVolterra, Gilead Sciences, Merck/MSD, Organobalance, and Seres Therapeutics.

All remaining authors have declared no conflicts of interest.

Figures

Fig. 1
Fig. 1
Diagnostic work-up of diarrhea (≥ 3 unformed bowel movements/24 h)
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Vehreschild MJ, Vehreschild JJ, Hubel K, Hentrich M, Schmidt-Hieber M, Christopeit M, et al. Diagnosis and management of gastrointestinal complications in adult cancer patients: evidence-based guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO) Ann Oncol. 2013;24:1189–1202. doi: 10.1093/annonc/mdt001. - DOI - PubMed
    1. Cornely OA, Cuenca-Estrella M, Meis JF, Ullmann AJ. European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Fungal Infection Study Group (EFISG) and European Confederation of Medical Mycology (ECMM) 2013 joint guidelines on diagnosis and management of rare and emerging fungal diseases. Clin Microbiol Infect. 2014;20(Suppl 3):1–4. doi: 10.1111/1469-0691.12569. - DOI - PubMed
    1. Einhorn LH, Rapoport B, Navari RM, Herrstedt J, Brames MJ. 2016 updated MASCC/ESMO consensus recommendations: prevention of nausea and vomiting following multiple-day chemotherapy, high-dose chemotherapy, and breakthrough nausea and vomiting. Support Care Cancer. 2017;25:303–308. doi: 10.1007/s00520-016-3449-y. - DOI - PubMed
    1. Kamboj M, Mihu CN, Sepkowitz K, Kernan NA, Papanicolaou GA. Work-up for infectious diarrhea after allogeneic hematopoietic stem cell transplantation: single specimen testing results in cost savings without compromising diagnostic yield. Transpl Infect Dis. 2007;9:265–269. doi: 10.1111/j.1399-3062.2007.00230.x. - DOI - PubMed
    1. Crobach MJ, Planche T, Eckert C, Barbut F, Terveer EM, Dekkers OM, et al. European Society of Clinical Microbiology and Infectious Diseases: update of the diagnostic guidance document for Clostridium difficile infection. Clin Microbiol Infect. 2016;22(Suppl 4):S63–S81. doi: 10.1016/j.cmi.2016.03.010. - DOI - PubMed

MeSH terms

Grants and funding

LinkOut - more resources