Gastrointestinal manifestations of graft-versus-host disease: diagnosis and management

The number of bone marrow transplantations performed to treat diseases such as leukemia, lymphoma, and aplastic anemia has been increasing during the past 2 decades. Improvements in histocompatibility testing, transfusion support, conditioning regimens, and antibiotics have dramatically improved survival after transplantation. As more patients survive the acute phase of bone marrow transplantation and leave major medical centers for their homes, healthcare providers across the country are caring for these patients and their transplantation-associated complications. Graft-versus-host disease (GVHD) of the skin, liver, and gastrointestinal tract are complications that patients may experience months after transplantation. As clinicians, advanced practice nurses encounter these patients in clinics, hospitals, and intensive care units, whether it be for specific GVHD-associated problems or other health conditions. This article reviews the current standards of care for the prevention, diagnosis, and treatment of GVHD of the gastrointestinal tract.