《Table 1 Colonoscopy and histology reports from previous case reports of capecitabine associated ile

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《Role of colonoscopy in diagnosis of capecitabine associated ileitis:Two case reports》

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To date，there have been only nine published cases describing capecitabine associated ileitis，and only four of these cases document use of colonoscopy in diagnosis[6-9].We are presenting the fifth and sixth case reports of colonoscopyassisted diagnosis of this condition.Combining our analysis of these six colonoscopy reports（Table 1），we have determined some patterns in the presentation of this condition.Firstly，capecitabine associated ileitis tends to localize in the terminal ileum.Secondly，a granular erythematous appearance of mucosa with ulcerations is commonly seen.Two of the six reports disclose a biopsy that is positive for eosinophilic infiltrates，and one report from our institution describes a pseudomembrane with inflammatory exudates.Given that the differential etiologies of diarrhea in a hospitalized patient is so broad（colitis，bacterial vs viral infection，inflammation，medication-induced）we believe that these findings collectively can improve the diagnostic accuracy of this condition and optimize treatment options.Additionally，we believe that colonoscopy with biopsy should be indicated as a standardized diagnostic measure in patients on capecitabine with diarrhea refractory to conservative methods.