What is chronic GVHD of the gut (stomach and intestines)?

Chronic graft-versus-host disease (GVHD) of the gut happens when donated cells a patient receives during a blood or marrow transplant (BMT) begin attacking the gut, including the stomach and intestines.

GVHD of the gut can affect how food moves through the digestive system and how well nutrients are absorbed. Symptoms may range from mild to severe and can overlap with other conditions or side effects of treatment.

• Nausea or vomiting
• Loss of appetite or feeling full quickly
• Indigestion, gas or bloating
• Abdominal pain or cramping
• Diarrhea
• Unintentional weight loss

To learn more about how GVHD can affect different parts of your body, view our full list of GVHD symptoms.

You may be able to ease digestive symptoms and support nutrition through daily care, medicines and diet adjustments. Always talk with your care team before making changes.

• Keep a list of what you eat and how you feel after.
• Avoid foods that trigger symptoms, such as spicy, oily or fatty foods. Dairy can also cause problems for some people.
• Take anti-nausea medicines before meals if your doctor prescribes them.
• See a dietitian if you are losing weight. They can help you find foods that are easier to eat and keep you healthy.

• Avoid foods that seem to cause diarrhea, such as greasy foods, caffeine or milk products.
• Ask your doctor about anti-diarrhea medicines like Imodium or Lomotil.
• Drink plenty of fluids such as water, broths or electrolyte drinks to stay hydrated.

• Your stomach or intestines hurt.
• You notice changes in your appetite, stool or weight.
• You develop new or worsening nausea, diarrhea or vomiting.

Your doctor may diagnose gut GVHD based on your symptoms, an exam and sometimes additional tests to make sure infections or other medicines are not causing your stomach problems.

Treatment for gut GVHD focuses on reducing inflammation, easing symptoms and protecting your nutrition. Your care team may recommend:

• Steroid medicines you swallow. These coat and calm the stomach and intestines without affecting the rest of your body. Examples include beclomethasone in corn oil and budesonide pills.
• Steroids for the whole body. Some people need systemic steroids such as prednisone to control GVHD in multiple areas.
• Supportive medicines. Your doctor may prescribe medicines like Zofran or Compazine for nausea or Imodium or Lomotil for diarrhea.
• Enzyme replacement therapy. If your pancreas is not making enough enzymes to digest food, you may have gas, bloating, oily stools or weight loss. Pills such as Creon can replace those enzymes and improve digestion.
• Nutrition support. If you are losing too much weight or cannot eat enough, you may need nutrition through an IV line or feeding tube. This helps your body heal and lowers the risk of infection.