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Gastrointestinal Side Effects
What are the Gastrointestinal Side Effects of CLL Treatments, and How are They Managed?
CLL-targeted therapies, like venetoclax and BTK inhibitors, can cause gastrointestinal (GI) side effects. This means they may affect the stomach and intestines. These medications are designed to target specific proteins involved in CLL cell growth—BCL-2 for venetoclax and BTK for BTK inhibitors—but they can also affect other proteins, leading to additional side effects beyond just killing CLL cells.
CLL patients may experience various GI side effects due to CLL or its treatments. Managing these side effects typically involves medications, dietary adjustments, and supportive care. It’s important to discuss any GI symptoms with a healthcare provider for appropriate treatment and relief.
Common GI side effects from CLL treatments and their management strategies include:
| GI Side Effect | Cause | Management |
| Nausea and vomiting | Often a result of targeted therapies. | Use antiemetics, eat smaller meals, and avoid strong odors. |
| Diarrhea | Can occur due to treatment or as a reaction to medications. | Antidiarrhea medicine, consider adding electrolytes to your hydration plan for the day. If you have more than 7 episodes in a day, it is considered severe. Have your doctor check for active stool infections. |
| Constipation | Some treatments, like ibrutinib, can slow down bowel movements. | Take laxatives, increase fiber intake, and stay hydrated. |
| Abdominal pain or cramping | Can be caused by the cancer, treatment side effects, or infections. | Use over-the-counter pain relievers and heat therapy. |
| Appetite loss | May be related to nausea, treatment side effects, or general illness. | Eat small, nutrient-dense meals and consider appetite stimulants. |
| Mouth sores | Some treatments can lead to painful sores in the mouth or throat. | Rinse your mouth with salt water or baking soda solutions and use topical treatments. CLL patients also recommend Biotene mouth rinses and toothpaste or other products with no alcohol. Your doctor may prescribe a mouthwash like diphenhydramine-maalox-lidocaine 1:1:1 Liquid (Magic Mouthwash). |