Capecitabine-Induced Ileitis: A Case Report and Review of the Literature

Capecitabine-induced ileitis is a rare but important complication, and awareness of this entity is crucial for oncologists and gastroenterologists to ensure timely recognition, appropriate management, and to avoid unnecessary interventions. We present the case of a 62-year-old woman with recurrent estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative left breast cancer who developed vomiting and diarrhea following an increased dose of capecitabine. She was managed conservatively with intravenous fluids, antibiotics, and antiemetics. Imaging suggested findings consistent with ileitis. She was advised to rest her bowel and gradually reintroduce oral intake as tolerated, while receiving symptom relief with antiemetics and loperamide for diarrhea. Her blood parameters were closely monitored, and electrolyte imbalances were corrected as needed. With symptomatic improvement, she was discharged and subsequently reviewed in the clinic. Based on the most recent imaging and evidence of disease progression, a new treatment regimen of exemestane combined with everolimus was initiated.