Chronic diarrhoea following surgery for colon cancer-frequency, causes and treatment options

Int J Colorectal Dis. 2018 Jun;33(6):683-694. doi: 10.1007/s00384-018-2993-y. Epub 2018 Mar 27.


Purpose: The growing population of survivors after colon cancer warrants increased attention to the long-term outcome of surgical treatment. The change in bowel anatomy after resection disrupts normal gastrointestinal function and may cause symptoms. Thus, many patients surviving colon cancer have to cope with bowel dysfunction for the rest of their lives. We here aim to provide an overview of the literature on this topic.

Methods: We review long-term functional outcomes of surgical treatment for colon cancer, the underlying pathology, and treatment options.

Results: Common symptoms include constipation, urge for defecation and diarrhoea. Causes of diarrhoea after colon cancer surgery are sparsely studied, but they probably include bile acid malabsorption, small intestinal bacterial overgrowth and disruption of the ileal brake. Specific diagnosis should be made to allow individual treatment based on the underlying pathology. Studies on treatment of functional problems after surgery for colon cancer are extremely few, but some lessons can be drawn from the treatment of other patient groups having undergone colon surgery.

Conclusion: Diarrhoea is likely a common long-term complication after colon cancer surgery. Attention to this complication and a specific diagnosis will aid the targeted treatment of patients suffering from this complication.

Keywords: Bile acid malabsorption; Colon cancer surgery; Complications to colon cancer; Diarrhoea.

Publication types

  • Review

MeSH terms

  • Chronic Disease
  • Colonic Neoplasms / surgery*
  • Diarrhea / epidemiology
  • Diarrhea / etiology*
  • Diarrhea / physiopathology
  • Diarrhea / therapy*
  • Humans
  • Models, Biological
  • Postoperative Complications / etiology*