Colitis and Opdivo

Opdivo, an immunotherapy, can cause many side effects. Some of which are itching, rash, fatigue, pneumonitis, and colitis. I have always had the rash and fatigue and it appears that I now have colitis. It was found during my every three month scans where part of my ascending colon showed thickening. I had recently had severe cramping and frequent bowel movements but really didn't think anything of it. (Do you see a pattern forming with me that I never "think anything of it.")

What is colitis?

Colitis is inflammation of the lining tissues of the large intestine (colon). Typical symptoms can include abdominal pain, cramping, bloating, and diarrhea (sometimes bloody diarrhea). Colitis can be part of a disease that affects other parts of the body, causing fever, chills, fatigue, malaise, and dehydration symptoms (weakness, decreased urine output). As I look back, I have had abdominal pain, cramping, and bloating. I never have had diarrhea, so again, I didn't think it was that bad.

Asking my doctor for guidance

Well, my oncologist thought otherwise. As soon as she saw my scan results, she stopped my Opdivo for a few cycles and had me take 40 mg of Prednisone each day for one week. Fast forward to the next oncologist appointment and none of the symptoms are getting better. Our next step is a colonoscopy so she can have a clear view of exactly what is going on with my colon. Many things can cause colitis ranging from viral infections to bacterial infections to, of course, Opdivo side effects.

Changing my diet to help

Some ways to help counteract the symptoms of colitis are to reduce intake of fried/greasy foods, no nuts/seeds or popocorn, no spicy foods, and raw vegetables. All of which are practically my favorite foods! I have been vigilant in reducing my intake of these foods but it is really taking its toll on me. I am grouchy and tired all the time.

According to the American Dietetic Association, it is recommended that you follow the below practices:

• Eat small meals every 3 or 4 hours.
• Drink at least 8 cups of water per day to avoid dehydration.
• Eat foods containing added probiotics and prebiotics to encourage better gut health.
• Limit oils to 8 teaspoons a day.

Follow up blood work and tests

A few other tests besides a colonoscopy may be blood work and stool samples to check for infection. A few suggestions to help you navigate your way through the symptoms are anti-gas pills/products, anti-diarrhea medicine if needed, and drink a lot of water. Don't take the chance of becoming dehydrated. And, most importantly, report any changes to your physical symptoms and health to your medical team.

Editor’s Note: We are extremely saddened to say that on January 28, 2020, Jennifer Toth passed away. Jennifer was a passionate advocate for the Lung Cancer community. She will be deeply missed.