Patients with gastrointestinal cancers often experience a constellation of symptoms including nausea, vomiting, diarrhea, constipation, anorexia, cachexia, and mucositis. These symptoms are either toxicities secondary to treatment and/or related to complications of the disease. Even relatively low-grade discomfort, especially when chronic, can have a significan impact on quality of life. Clinicans should be diligent in routinely assessing patients for these distressing symptoms making every effort to maximize available preventative and treatment strategies.