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Intake of citrus fruits and vegetables and the intensity of defecation urgency syndrome among gynecological cancer survivors

Journal article
Authors Maria Hedelin
Viktor Skokic
Ulrica Wilderäng
Rebecka Ahlin
Cecilia Bull
Fei Sjöberg
Gail Dunberger
Karin Bergmark
A. Stringer
Gunnar Steineck
Published in PLoS ONE
Volume 14
Issue 1
ISSN 1932-6203
Publication year 2019
Published at Institute of Clinical Sciences, Department of Oncology
Language en
Keywords acute gastrointestinal toxicity, inflammatory-bowel-disease, dietary, fiber, radiation-therapy, gut microbiota, butyrate, colon, radiotherapy, symptoms, barrier
Subject categories Cancer and Oncology


Background Despite the experimental evidence that certain dietary compounds lower the risk of radiation-induced damage to the intestine, clinical data are missing and dietary advice to irradiated patients is not evidence-based. We have previously identified 28 intestinal health-related symptoms among 623 gynaecological-cancer survivors (three to fifteen years after radiotherapy) and 344 matched population-based controls. The 28 symptoms were grouped into five radiation-induced survivorship syndromes: defecation-urgency syndrome, fecal-leakage syndrome, excessive mucus discharge, excessive gas discharge and blood discharge. The grouping was based on factor scores produced by Exploratory Factor Analysis in combination with the Variable Cutoff Method. Frequency of food intake was measured by a questionnaire. We evaluated the relationship between dietary intake and the intensity of the five syndromes. With the exception of excessive mucus discharge, the intensity of all syndromes declined with increasing intake of citrus fruits. The intensity of defecation-urgency and fecal-leakage syndrome declined with combined intake of vegetables and citrus fruits. The intensity of excessive mucus discharge was increased with increasing intake of gluten. In this observational study, we found an association between a high intake of citrus fruits and vegetables and a lower intensity of the studied radiation-induced cancer survivorship syndromes. Our data suggest it may be worthwhile to continue to search for a role of the diet before, during and after radiotherapy to help the cancer survivor restore her or his intestinal health after irradiation.

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