Immune-related gastrointestinal toxicity

Immune-related gastrointestinal toxicity

STARTFINISHCreated with SnapWhat grade?STARTFINISHCreated with SnapGrade 1< 4 liquid stools perdaySystemically wellSTARTFINISHCreated with SnapAssessment-FBC, U&E, LFT, CRP,TFT.-Stool microscopy,culture and C diff.STARTFINISHCreated with SnapManagement-Proceed withtreatment.-Oral fluids,loperamide, avoidhigh fibre/lactose diet.STARTFINISHFollow-upG1 persist for >14days treat as G2.STARTFINISHCreated with SnapGrade 24-6 liquid stools perday OR abdominalpain OR PR bleed ORnausea OR nocturalepisodesSTARTFINISHCreated with SnapAssessment(see info)STARTFINISHCreated with SnapManagement-Witholdimmunotherapy-If G2 > 3 days orworsening, start oralprednisolone...STARTFINISHFollow-up(see info)STARTFINISHCreated with SnapGrade 3> 7 stools per daySystemically unwellSTARTFINISHCreated with SnapAssessment(see info)STARTFINISHCreated with SnapManagement(see info)STARTFINISHFollow-upOnce improved, weansteroids by 5mg everyweek.