Ando Takayuki, Sakumura Miho, Mihara Hiroshi, Fujinami Haruka, Yasuda Ichiro
Third Department of Internal Medicine, Faculty of Medicine, University of Toyama, Toyama 930-0194, Japan.
Healthcare (Basel). 2022 Jan 24;10(2):218. doi: 10.3390/healthcare10020218.
Chemotherapy-induced diarrhea (CID) is a common, severe side effect of chemotherapy, immunotherapy, and targeted therapy. Because patients are more prone to continuing chemotherapy if they do not suffer from CID, appropriate diagnosis and monitoring of this disease are essential. However, suitable monitoring methods are yet to be developed. To date, several studies have shown that small-bowel capsule endoscopy (SBCE) is useful in visualizing the entire small intestinal mucosa and detecting small intestinal abnormalities, including bleeding, malignant tumors, and mucosal injury, associated with the use of nonsteroidal anti-inflammatory drugs and low-dose aspirin. Currently, limited studies have evaluated the small intestinal mucosa using SBCE in patients receiving fluoropyrimidine-based chemotherapy or immune checkpoint inhibitors. These studies have reported that small intestinal mucosal injury is common in patients with severe fluoropyrimidine-induced diarrhea. SBCE might be a useful screening method for the early detection of enterocolitis induced by immune checkpoint inhibitors. SBCE may be a powerful tool for the diagnosis and monitoring of CID, and understanding its indication, contraindication, and capsule-retention risk for each patient is important for clinicians.
化疗引起的腹泻（CID）是化疗、免疫疗法和靶向治疗常见的严重副作用。由于患者若不患CID则更倾向于继续化疗，因此对该疾病进行恰当诊断和监测至关重要。然而，合适的监测方法尚未开发出来。迄今为止，多项研究表明，小肠胶囊内镜检查（SBCE）有助于观察整个小肠黏膜，并检测与使用非甾体抗炎药和低剂量阿司匹林相关的小肠异常情况，包括出血、恶性肿瘤和黏膜损伤。目前，仅有有限的研究使用SBCE评估接受氟嘧啶类化疗或免疫检查点抑制剂治疗患者的小肠黏膜。这些研究报告称，严重氟嘧啶引起的腹泻患者中，小肠黏膜损伤很常见。SBCE可能是早期检测免疫检查点抑制剂引起的小肠结肠炎的有用筛查方法。SBCE可能是诊断和监测CID的有力工具，了解其对每位患者的适应症、禁忌症和胶囊滞留风险对临床医生很重要。
