Xeloda and abdominal pain

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Nicolouna
Posts: 39
Joined: Fri Nov 08, 2013 6:30 pm

Xeloda and abdominal pain

Postby Nicolouna » Sat Dec 26, 2020 9:53 pm

Hi all,

I am on my second cycle of XELOX. On Day 10 (out of 14) of xeloda. Since 3 days ago, I am feeling lower abdominal pain especially after eating for a few hours. The pain is always there but aggravated by eating. It feels like my bowels are super inflamed. I am passing gas and stool normally, don’t have any abdominal distension or fever or any other symptoms. The pain is pretty significant because I can’t laugh or cough without feeling it and changes of position are painful. It feels like my bowels are angry. I’ve been taking Tylenol with some relief of pain but it’s a type of pain that moves as (what I think) food is passing through the bowels. I didn’t have this side effect during my first cycle so naturally I am worried. Did any of you on xeloda experience this? I am planning on calling my onco first thing Monday morning. Hoping to not need a visit to the emergency room on a Sunday.
Dx @ 27yo, female w colon cancer (T4N0M0)
Aug 2013: R hemicolectomy
FOLFOX: Oct 2013-April 2014, NED
May 2016: had a baby ❤️
June 2017: L ovary met, surgical removal
July 2017: pancreatic met
Aug 2017: FOLFIRI
Dec 2017: Whipple’s. 1/36 nodes+
May 2018: 12 FOLFIRI done, NED
Sept 2018: abnormal cyst R ovary - surgery, no cancer (false alarm)
Dec 2019: abdo wall met, resected, clear margins
Oct 2020: new primary colon ca (T4N0), partial colectomy
Nov 2020: XELOX reaction, converted to FOLFOX

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beach sunrise
Posts: 1034
Joined: Thu Mar 05, 2020 7:14 pm

Re: Xeloda and abdominal pain

Postby beach sunrise » Sun Dec 27, 2020 2:02 am

Hi, I haven't experienced your side effects. Are you watching folic acid intake? I try to avoid folic acid at all costs.
Maybe a good pre and probiotic would help also?
Just some thoughts.
8/19 RC CEA 82.6 T3N0M0
5FU/rad 6 wk
IVC 75g 1 1/2 wks before surgery. Continue 2x a week
Surg 1/20 -margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24 post 5.9
FOLFOX
7 rds 6-10 CEA 11.4 No more
CEA
7/20 11.1 8.8
8/20 7.8
9/20 8.8, 9, 8.6
10/20 8.1
11/20 8s
12/20 8s-9s
ADAPT++++ chrono
CEA
10/23/22 26.x
12/23/22 22.x
2023
1/5 17.1
1/20 15.9
3/30 14.9
6/12 13.3
8/1 2.1
Nodule RML SUV 1.3 5mm
Rolles 3 of 4 lung nodules cancer
KRAS
Chem-sens test failed Not enough ca cells to test

Nicolouna
Posts: 39
Joined: Fri Nov 08, 2013 6:30 pm

Re: Xeloda and abdominal pain

Postby Nicolouna » Sun Dec 27, 2020 3:45 am

beach sunrise wrote:Hi, I haven't experienced your side effects. Are you watching folic acid intake? I try to avoid folic acid at all costs.
Maybe a good pre and probiotic would help also?
Just some thoughts.


No I’m not watching my folic acid intake... didn’t know it was a thing!
Dx @ 27yo, female w colon cancer (T4N0M0)
Aug 2013: R hemicolectomy
FOLFOX: Oct 2013-April 2014, NED
May 2016: had a baby ❤️
June 2017: L ovary met, surgical removal
July 2017: pancreatic met
Aug 2017: FOLFIRI
Dec 2017: Whipple’s. 1/36 nodes+
May 2018: 12 FOLFIRI done, NED
Sept 2018: abnormal cyst R ovary - surgery, no cancer (false alarm)
Dec 2019: abdo wall met, resected, clear margins
Oct 2020: new primary colon ca (T4N0), partial colectomy
Nov 2020: XELOX reaction, converted to FOLFOX

stu
Posts: 1613
Joined: Sat Aug 17, 2013 5:46 pm

Re: Xeloda and abdominal pain

Postby stu » Sun Dec 27, 2020 6:57 am

Hi ,
My mum had xeloda for two years on and off . It gave her terrible colic type pains . Over the counter buscopan helped . The second year she had a small reduction in her dose and it really reduced her symptoms . I am no doctor but the opinion from the medical world was it affects the digestive tract.
It’s been a long time since she was on it but I still remember her suffering with it .
However it was super effective at doing its job too! Glad you are seeking help early on it and get on top of it . It took us to the second year !! Still feel a little guilty about that .
Stu
supporter to my mum who lives a great life despite a difficult diagnosis
stage4 2009 significant spread to liver
2010 colon /liver resection
chemo following recurrence
73% of liver removed
enjoying life treatment free
2016 lung resection
Oct 2017 nice clear scan . Two lung nodules disappeared
Oct 2018. Another clear scan .

Nicolouna
Posts: 39
Joined: Fri Nov 08, 2013 6:30 pm

Re: Xeloda and abdominal pain

Postby Nicolouna » Sun Dec 27, 2020 4:03 pm

Update for you all: had a night with loads of abdo pain so I decided to go to ER today. Turns out my bowels are completely twisted and full of air. I am stopping Xeloda for now and being admitted as I am at risk of bowel perforation. The onc on call said that probably the chemo burnt/ irritated the bowels to this point and that I did the right thing by coming in today. I’m bummed but hope it’s just another bump in the road.
Dx @ 27yo, female w colon cancer (T4N0M0)
Aug 2013: R hemicolectomy
FOLFOX: Oct 2013-April 2014, NED
May 2016: had a baby ❤️
June 2017: L ovary met, surgical removal
July 2017: pancreatic met
Aug 2017: FOLFIRI
Dec 2017: Whipple’s. 1/36 nodes+
May 2018: 12 FOLFIRI done, NED
Sept 2018: abnormal cyst R ovary - surgery, no cancer (false alarm)
Dec 2019: abdo wall met, resected, clear margins
Oct 2020: new primary colon ca (T4N0), partial colectomy
Nov 2020: XELOX reaction, converted to FOLFOX

stu
Posts: 1613
Joined: Sat Aug 17, 2013 5:46 pm

Re: Xeloda and abdominal pain

Postby stu » Mon Dec 28, 2020 3:45 am

So sorry to hear that . What a good job you checked that out .

Hope your bowel settles and recovers quickly . I c as n totally understand your concerns . Hope your team get a good plan in place for you .
Stu
supporter to my mum who lives a great life despite a difficult diagnosis
stage4 2009 significant spread to liver
2010 colon /liver resection
chemo following recurrence
73% of liver removed
enjoying life treatment free
2016 lung resection
Oct 2017 nice clear scan . Two lung nodules disappeared
Oct 2018. Another clear scan .

Rikimaroo
Posts: 436
Joined: Tue Dec 20, 2016 8:48 pm
Location: Florida

Re: Xeloda and abdominal pain

Postby Rikimaroo » Mon Dec 28, 2020 2:13 pm

Nicolina,

I have abdominal pain with Xeloda. It has been ups and down of severe pain to whirring in my stomach/abdomen. The Whirring is what tells me that I know I have trapped gas. Usually it follows with pebble like poop coming out of my ostomy. If I lie on my right side gas does come out after a major whirring noise. The issue seems to be stuck gas in the abdomen. I didn't and never have gone to the ER, kind of tired of running to doctors for everything.

My pain has been excruciating to mild. I have started taken oregano tea at night, Beano pills before meals, or right after if I forget and it seems to have helped. I still have gas/whirring noises, but not the pain typically associated with it. I recommend trying Oregano Tea/Beano tablets. It's not 100% but it lessens the degree of pain/discomfort from abdominal side effects of Xeloda. I take it 3 in morning and 3 at night and have sometimes only taken 3 a day the Xeloda that is. I don't stick to regimen always and I mentioned to my Onc and he is ok with it, just manage my side effects as long things are working. You are taken OXI with yours so you might be able to reduce or take less tablets per day. Play it by ear based on how you are feeling. OXI is much more powerful and toxic as hell.

One thing I found is onions and cabbage are a no no. Causes major gas pains. I think the beano has helped, but I still try to avoid.

https://www.amazon.com/gp/product/B01F9 ... UTF8&psc=1
RC T3N1M0 12/16
MSS - NRAS Mutation
Chemo Rad, CCR - W&W 5/2017
Recurrence 11/2017
CT Scan 11/2017 Liver Met 5.5cm Stable, Stage IV
LAR/Liver Resect 4/2018
Reversal 10/18
CEA highest 500, lowest .8 throughout process, waiting for latest
Recurrence left vesical/pelvic sidewall - 10/7/2019 resect perm bag,
CEA rise Feb/May 3.7, 8.8, 30, Recurrence in Pelvic
CEA 40 right now, but was 57, so folfiri to beat it back down.
Lots of chemo for the past 4 years.

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Green Tea
Posts: 451
Joined: Mon Oct 24, 2016 10:48 am

Re: Xeloda and abdominal pain

Postby Green Tea » Wed Dec 30, 2020 4:33 am

Nicolouna wrote:... I am on my second cycle of XELOX. On Day 10 (out of 14) of xeloda. Since 3 days ago, I am feeling lower abdominal pain especially after eating for a few hours. The pain is always there but aggravated by eating. It feels like my bowels are super inflamed...

Last edited by Green Tea on Wed Dec 30, 2020 2:34 pm, edited 1 time in total.

rtomlin
Posts: 4
Joined: Mon Sep 03, 2018 3:07 pm

Re: Xeloda and abdominal pain

Postby rtomlin » Wed Dec 30, 2020 6:17 am

Immodium godsend to me in avoiding diarrhea and likely ab pains during 6 rounds of Xeloda

Nicolouna
Posts: 39
Joined: Fri Nov 08, 2013 6:30 pm

Re: Xeloda and abdominal pain

Postby Nicolouna » Wed Dec 30, 2020 3:25 pm

I’m still in hospital being treated with IV antibiotics. Seems I had a pretty bad colitis, with some fluid accumulation/abscess in the bowels. It’s been getting better slowly. So annoyed. Don’t know what this means for my remaining 6 cycles. I will be scanned tomorrow to see the response of the abscess to the IV antibiotics and hopefully be home in time for NYE. I did take xeloda as prescribed, within 30 mins (usually have a 15 mins timer after I eat) of meals, eat BRAT diet and actually didn’t have much diarrhea, maybe once every 2-3 days. Otherwise prior to the pain I just had a lot of cramping action.
Dx @ 27yo, female w colon cancer (T4N0M0)
Aug 2013: R hemicolectomy
FOLFOX: Oct 2013-April 2014, NED
May 2016: had a baby ❤️
June 2017: L ovary met, surgical removal
July 2017: pancreatic met
Aug 2017: FOLFIRI
Dec 2017: Whipple’s. 1/36 nodes+
May 2018: 12 FOLFIRI done, NED
Sept 2018: abnormal cyst R ovary - surgery, no cancer (false alarm)
Dec 2019: abdo wall met, resected, clear margins
Oct 2020: new primary colon ca (T4N0), partial colectomy
Nov 2020: XELOX reaction, converted to FOLFOX

User avatar
Green Tea
Posts: 451
Joined: Mon Oct 24, 2016 10:48 am

Re: Xeloda and abdominal pain

Postby Green Tea » Thu Dec 31, 2020 12:40 am

I'm sorry to hear that you are still in the hospital. You have really been through the wringer these past few years with all of your abdominal surgeries.

Could the current problem be due to adhesions from all your past abdominal surgeries? Maybe the CT scan will shed some light on the source of the problem.

Image

Adhesions and small bowel obstruction (SBO)
https://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=52932&p=417613#p417613

https://www.webmd.com/digestive-disorders/what-is-bowel-obstruction

Nicolouna
Posts: 39
Joined: Fri Nov 08, 2013 6:30 pm

Re: Xeloda and abdominal pain

Postby Nicolouna » Thu Dec 31, 2020 4:35 am

Green Tea wrote:I'm sorry to hear that you are still in the hospital. You have really been through the wringer these past few years with all of your abdominal surgeries.

Could the current problem be due to adhesions from all your past abdominal surgeries? Maybe the CT scan will shed some light on the source of the problem.

Image

Adhesions and small bowel obstruction (SBO)
https://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=52932&p=417613#p417613

https://www.webmd.com/digestive-disorders/what-is-bowel-obstruction


Could be. Although my surgeon who operated on me 3 months ago said that I surprisingly had very few adhesions for the number of surgeries I’ve done. So who knows!
Dx @ 27yo, female w colon cancer (T4N0M0)
Aug 2013: R hemicolectomy
FOLFOX: Oct 2013-April 2014, NED
May 2016: had a baby ❤️
June 2017: L ovary met, surgical removal
July 2017: pancreatic met
Aug 2017: FOLFIRI
Dec 2017: Whipple’s. 1/36 nodes+
May 2018: 12 FOLFIRI done, NED
Sept 2018: abnormal cyst R ovary - surgery, no cancer (false alarm)
Dec 2019: abdo wall met, resected, clear margins
Oct 2020: new primary colon ca (T4N0), partial colectomy
Nov 2020: XELOX reaction, converted to FOLFOX

User avatar
Green Tea
Posts: 451
Joined: Mon Oct 24, 2016 10:48 am

Re: Xeloda and abdominal pain

Postby Green Tea » Fri Jan 01, 2021 12:53 am

Nicolouna wrote:I’m still in hospital being treated with IV antibiotics...

If you re still in the hospital after New Year's Day you might ask the doctor a few questions: For example, which IV antibiotic is being used, how long is the standard course of treatment for this antibiotic, and what are the plans if this antibiotic turns out not to be working as expected?

Also, it would be interesting to know what kind of abscess they are treating. Is it some sort of diverticulitis? Is it an ulcer that has become infected? Is it a wound from your recent bowel surgery that has not completely healed?

And do they know what kind of bacteria is causing the infection?

The reason I mention this is that there are different types of bacteria and different categories of antibiotics, and successful treatment of a condition requires that an appropriate antibiotic be used to treat the presumed infection. Sometimes it requires a cocktail of several different antibiotics or meds administered at the same time.

For example, if your initial IV antibiotic was Flagyl (metronidazole), then it is for Gram-positive bacteria only and will not work at all for Gram-negative bacteria. If your abscess is caused in fact by a Gram-negative bacteria, then something like Meropenem might be more appropriate.

stu
Posts: 1613
Joined: Sat Aug 17, 2013 5:46 pm

Re: Xeloda and abdominal pain

Postby stu » Fri Jan 01, 2021 4:47 pm

Hope you get home soon .

Stu
supporter to my mum who lives a great life despite a difficult diagnosis
stage4 2009 significant spread to liver
2010 colon /liver resection
chemo following recurrence
73% of liver removed
enjoying life treatment free
2016 lung resection
Oct 2017 nice clear scan . Two lung nodules disappeared
Oct 2018. Another clear scan .

Nicolouna
Posts: 39
Joined: Fri Nov 08, 2013 6:30 pm

Re: Xeloda and abdominal pain

Postby Nicolouna » Fri Jan 01, 2021 5:48 pm

Green Tea wrote:
Nicolouna wrote:I’m still in hospital being treated with IV antibiotics...

If you re still in the hospital after New Year's Day you might ask the doctor a few questions: For example, which IV antibiotic is being used, how long is the standard course of treatment for this antibiotic, and what are the plans if this antibiotic turns out not to be working as expected?

Also, it would be interesting to know what kind of abscess they are treating. Is it some sort of diverticulitis? Is it an ulcer that has become infected? Is it a wound from your recent bowel surgery that has not completely healed?

And do they know what kind of bacteria is causing the infection?

The reason I mention this is that there are different types of bacteria and different categories of antibiotics, and successful treatment of a condition requires that an appropriate antibiotic be used to treat the presumed infection. Sometimes it requires a cocktail of several different antibiotics or meds administered at the same time.

For example, if your initial IV antibiotic was Flagyl (metronidazole), then it is for Gram-positive bacteria only and will not work at all for Gram-negative bacteria. If your abscess is caused in fact by a Gram-negative bacteria, then something like Meropenem might be more appropriate.


I was on Tazocin IV for 3 days. My scan showed a decrease in the size of the abscess by almost 50% so they were pleased with the response. They switched me to oral cipro and flagyl (metronidazole) which I am to take for another 11 days (14 days total of antibiotics). Didn’t have recurrent fever so they discharged me home today. I feel better, almost no pain and can tolerate a solid diet without issues. Still have some diarrhea but I know I’m under the effects of Xeloda and the antibiotics can make diarrhea worse. I don’t have answers as to whether this is diverticulitis, a very late (and improbable according to my surgeon) anastomotic leak or infectious ulcer. They said they can’t tell unless they go in and drain it which they don’t need to as it is shrinking. The latest running theory is that the xeloda triggered severe colitis near the anastomotic site and that caused a micro leak. I will be closely followed the next 2 weeks by my onco and surgeon so we will see how this evolves and hopefully resolved. All this to say I’m for sure not going to be receiving my 3rd cycle of XELOX next week.
Dx @ 27yo, female w colon cancer (T4N0M0)
Aug 2013: R hemicolectomy
FOLFOX: Oct 2013-April 2014, NED
May 2016: had a baby ❤️
June 2017: L ovary met, surgical removal
July 2017: pancreatic met
Aug 2017: FOLFIRI
Dec 2017: Whipple’s. 1/36 nodes+
May 2018: 12 FOLFIRI done, NED
Sept 2018: abnormal cyst R ovary - surgery, no cancer (false alarm)
Dec 2019: abdo wall met, resected, clear margins
Oct 2020: new primary colon ca (T4N0), partial colectomy
Nov 2020: XELOX reaction, converted to FOLFOX


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