The Digestive System After Childhood Cancer

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Treatment for childhood cancer can sometimes cause scarring and ongoing problems in the bowel or other parts of the digestive system. The digestive system is also called the gastrointestinal system. It is made up of the organs that break down food for growth and energy.

Am I at Risk?

Certain treatments for childhood cancer increase risk for digestive problems. Mainly, they are surgery involving the abdomen or pelvis and radiation to the neck, chest, abdomen, or pelvis.

Other factors that raise risk for digestive problems include:

  • a personal history of bowel scarring (adhesions), bowel blockage (obstruction), or chronic graft-versus-host disease of the intestinal tract
  • a family history of gallstones or colorectal or esophageal cancer
  • tobacco use

What Digestive System Problems Can Occur?

The types of problems that can arise depend on the location of surgery, the radiation treatment field, and the radiation dose. Digestive system problems that can occur include:

  • bowl blockage
  • scarring and narrowing of the tube that delivers food from the mouth to the stomach
  • gallstones
  • hardening or scarring of the liver
  • chronic diarrhea and stomach pain from ongoing inflammation of the intestines
  • colorectal cancer (see related Health Link: “Colorectal Cancer“)

What Are the Symptoms of Digestive System Problems?

Symptoms of digestive system problems include:

  • chronic heartburn
  • difficult or painful swallowing
  • chronic nausea or vomiting
  • stomach pain
  • chronic diarrhea
  • chronic constipation
  • black, tarry stools or blood in stool
  • weight loss
  • changes in appetite
  • abdominal distension or feeling bloated
  • yellow eyes or skin (jaundice; see related Health Link: “Liver Health after Childhood Cancer“)

See your doctor if you develop any of these symptoms. If symptoms come on quickly or are severe, call your doctor right away. You may need to be evaluated.

Should I Be Screened for Digestive System Problems?

Survivors at risk for digestive problems and those who are having digestive problems should be screening every year at their annual physical examination for problems that affect the digestive system involves an annual physical examination by a qualified health care professional. Blood tests, x-rays, and testing for small amounts of blood in the stool are sometimes needed. If gallstones or gallbladder problems are suspected, you might need an ultrasound. If your colon or esophagus needs to be checked, you might have a colonoscopy or endoscopy.

How Can I Keep My Digestive System Healthy?

You can lower your risk for digestive system problems by keeping a healthy lifestyle.

Eat Right

Follow these tips to eat right. For more information, see the related Health Link: “Eating Right and Being Active after Childhood Cancer.”

  • Choose a variety of foods from all the food groups. The SuperTracker at can help you create a personalized nutrition plan.
  • Make half your plate fruits and veggies.
  • Choose foods and drinks with little or no added sugars.
  • Make at least half your grains whole grains.
  • Eat fewer foods that are high in solid fats (such as beef fat, butter, and shortening).
  • Switch to low-fat or skim milk.
  • Avoid salt-cured, smoked, charbroiled, and pickled foods.

Avoid Habits that Cause Cancer

Heavy drinkers, especially those who use tobacco, have a higher risk for cancer and other digestive system problems. Follow these rules to help keep your risk down.

  • Don’t smoke or use tobacco products.
  • Avoid second-hand smoke when possible.
  • If you drink alcohol, limit yourself to fewer than two drinks per day.

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