The Dietotherapy of Malignant Degeneration of Small Intestine and Colon, Correlated with the Anticancerous Therapy

The presence of primary or metastatic cancer in small intestine has as a first line treatment the segmental resection. We reach the same therapeutic conduct in case of cancerous patients exposed to abdominal radiation therapy, sometimes severily affecting the small intestine (perforations, strictures, hemorrhages, fistulae). The nutritional implications of intestinal resection are significant, given the role of small intestine in digestion and absorbtion of nutricious principles, and the maintainance of enterohepatic circulation of biliary salts [1].
When we resort to ileal resection, if it does not exceed 100 cm, then a considerable part of biliary salts can not enter the reversed hepatic circuit (the surface for intestinal absorbtion diminishes) and they enter the colon, where they induce a watery diarrhea. It can be avoided if the patient is administered cholestyramine (it binds biliary salts, making them unable to induce diarrhea). Dietary measures alone are not sufficient. We start with 4 grams of cholestyramine per day, dosage after which the diarrhea stops abruptly. Afterwards, the dosage is decreased to half or less. In the mentioned conditions, though a part of the biliary salts loose their capacity to emulsify fats, the absorbtion of fats is not considerably disturbed [2].