Peer-review started: August 11, 2015
First decision: September 11, 2015
Revised: October 28, 2015
Accepted: November 17, 2015
Article in press: November 25, 2015
Published online: February 6, 2016
Processing time: 170 Days and 23.1 Hours
Diarrhea is a common complication of allogeneic hematopoietic stem cell transplant (HSCT), with an average incidence of approximately 40%-50%. A wide variety of etiologies can contribute to diarrhea in HSCT patients, including medication-induced mucosal inflammation, infections, graft-vs-host disease and cord colitis syndrome in umbilical cord blood transplant. Clinical manifestations can vary from isolated diarrheal episodes, to other organ involvement including pneumonia or myocarditis, and rarely multiorgan failure. The approach for diagnosis of diarrheal disorders in HSCT patients depends on the most likely cause. Given the risk of life-threatening conditions, the development of clinically significant diarrhea requires prompt evaluation, supportive care and specific therapy, as indicated. Serious metabolic and nutritional disturbances can happen in HSCT patients, and may even lead to mortality. In this review, we aim to provide a practical approach to diagnosis and management of diarrhea in the post-transplant period.
Core tip: Diarrhea is a common complication following allogeneic hematopoietic stem cell transplant. However, there is no recent review dedicated to guiding clinicians about the different causes and their management. Our objective is to conduct a thorough review of literature to provide a working schema for the busy clinician on evaluation and management of diarrhea in this special population.