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Case report
Treatment-resistant severe capecitabine-induced diarrhoea resolved with oral budesonide
  1. John Shumar1,
  2. Zachary Junga2,
  3. Jeptha T Johnson3 and
  4. Lawrence Goldkind2
  1. 1Internal Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
  2. 2Gastroenterology, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
  3. 3Pathology and Laboratory Services, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
  1. Correspondence to Dr John Shumar;{at}


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.

  • colon cancer
  • pathology
  • drugs: gastrointestinal system
  • gastroenterology
  • gastrointestinal system

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  • Contributors JS wrote the manuscript and is the corresponding author and article guarantor. JTJ provided the pathology images and their expert interpretation. ZJ helped to revise the manuscript. LG helped to revise and approved the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.