Radiation proctitis history and symptoms: Difference between revisions
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{{Radiation proctitis}} | {{Radiation proctitis}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}} [[User:Rekha|Rekha, M.D.]], {{MIR}} | ||
==Overview== | ==Overview== | ||
The most common symptoms of radiation proctitis include mild [[diarrhea]], [[tenesmus]], fecal urgency and mucus discharge. Less common symptoms of radiation proctitis include [[abdominal pain]], [[constipation]], severe [[diarrhea]] and rectal bleeding. | |||
==History and Symptoms== | ==History and Symptoms== | ||
===History=== | ===History=== | ||
History plays a pivotal role in diagnosing the radiaition proctitis and to exclude other differentials therefore history should include:<ref name="pmid8677984">{{cite journal| author=Babb RR| title=Radiation proctitis: a review. | journal=Am J Gastroenterol | year= 1996 | volume= 91 | issue= 7 | pages= 1309-11 | pmid=8677984 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8677984 }}</ref> | |||
*[History | |||
*[History | *Exposure to the radiation | ||
*[ | *Recent history of travel | ||
*Recent [[parasitic infection]] | |||
*History or risk factors for [[Sexually transmitted disease|STD]] | |||
*Recent use of [[Antibiotic|antibiotics]] or [[Non-steroidal anti-inflammatory drug|NSAIDS]] | |||
*History of [[atherosclerosis]] | |||
*[[Immunosuppression]] | |||
===Common Symptoms=== | ===Common Symptoms=== | ||
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===Less Common Symptoms=== | ===Less Common Symptoms=== | ||
Less common symptoms of | Less common symptoms of radiation proctitis include | ||
*Abdominal pain | *[[Abdominal pain]] | ||
*Constipation | *[[Constipation]] | ||
*Severe | *Severe [[diarrhea]] | ||
*Rectal bleeding | *Rectal bleeding | ||
=== Acute radiation proctitis === | |||
Symptoms occur in the first few weeks after therapy. These symptoms include [[diarrhea]] and the urgent need to [[Defecation|defecate]], often with inability to do so ([[tenesmus]]). Acute radiation proctitis usually resolves without treatment after several months, but symptoms may improve with [[butyric acid|butyrate]] [[enema]]s. This acute phase is due to direct damage of the lining ([[epithelium]]) of the colon. <ref>Babb RR. ''Radiation proctitis: a review.'' Am J Gastroenterol. 1996 Jul;91(7):1309-11. Review. PMID 8677984</ref> | Symptoms occur in the first few weeks after therapy. These symptoms include [[diarrhea]] and the urgent need to [[Defecation|defecate]], often with inability to do so ([[tenesmus]]). Acute radiation proctitis usually resolves without treatment after several months, but symptoms may improve with [[butyric acid|butyrate]] [[enema]]s. This acute phase is due to direct damage of the lining ([[epithelium]]) of the colon. <ref>Babb RR. ''Radiation proctitis: a review.'' Am J Gastroenterol. 1996 Jul;91(7):1309-11. Review. PMID 8677984</ref> | ||
===Chronic radiation proctitis=== | ===Chronic radiation proctitis=== | ||
Symptoms may begin as early as several months after therapy but occasionally not until several years later. These symptoms include diarrhea, [[Hematochezia|rectal bleeding]], painful defecation, and intestinal blockage. Intestinal blockage is a result of [[Stenosis|narrowing]] of the rectum which blocks the flow of [[feces]] due to stricture and results in symptoms in the form of [[constipation]], rectal pain, urgency, and rarely [[fecal incontinence]] due to overflow. Connections [[fistulae]] may also develop between the colon and other parts of the body such as the [[skin]] or [[urinary system]]. Inury to the nearby organs can lead to [[cystitis]], urethral stenosis, [[small bowel obstruction]] and [[Small intestinal bacterial overgrowth syndrome|small bowel bacterial overgrowth]]. | |||
Symptoms may begin as early as several months after therapy but occasionally not until several years later. These symptoms include diarrhea, [[Hematochezia|rectal bleeding]], painful defecation, and intestinal blockage. Intestinal blockage is a result of [[Stenosis|narrowing]] of the rectum which blocks the flow of [[feces]] due to stricture and results in symptoms in the form of constipation,rectal pain,urgency, and rarely | <br />[[Image:Radiation proctitis APC.jpg|center|thumb|200px|[[Colonoscopy|Endoscopic]] image of radiation proctitis before and after therapy with [[argon plasma coagulation]].]] | ||
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==References== | ==References== | ||
Latest revision as of 23:53, 6 November 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rekha, M.D., Mahshid Mir, M.D. [2]
Overview
The most common symptoms of radiation proctitis include mild diarrhea, tenesmus, fecal urgency and mucus discharge. Less common symptoms of radiation proctitis include abdominal pain, constipation, severe diarrhea and rectal bleeding.
History and Symptoms
History
History plays a pivotal role in diagnosing the radiaition proctitis and to exclude other differentials therefore history should include:[1]
- Exposure to the radiation
- Recent history of travel
- Recent parasitic infection
- History or risk factors for STD
- Recent use of antibiotics or NSAIDS
- History of atherosclerosis
- Immunosuppression
Common Symptoms
Common symptoms of Radiation proctitis include:
- Changes in bowel habits,usually mild diarrhea
- Tenesmus
- Fecal urgency
- Mucus discharge
Less Common Symptoms
Less common symptoms of radiation proctitis include
- Abdominal pain
- Constipation
- Severe diarrhea
- Rectal bleeding
Acute radiation proctitis
Symptoms occur in the first few weeks after therapy. These symptoms include diarrhea and the urgent need to defecate, often with inability to do so (tenesmus). Acute radiation proctitis usually resolves without treatment after several months, but symptoms may improve with butyrate enemas. This acute phase is due to direct damage of the lining (epithelium) of the colon. [2]
Chronic radiation proctitis
Symptoms may begin as early as several months after therapy but occasionally not until several years later. These symptoms include diarrhea, rectal bleeding, painful defecation, and intestinal blockage. Intestinal blockage is a result of narrowing of the rectum which blocks the flow of feces due to stricture and results in symptoms in the form of constipation, rectal pain, urgency, and rarely fecal incontinence due to overflow. Connections fistulae may also develop between the colon and other parts of the body such as the skin or urinary system. Inury to the nearby organs can lead to cystitis, urethral stenosis, small bowel obstruction and small bowel bacterial overgrowth.
References
- ↑ Babb RR (1996). "Radiation proctitis: a review". Am J Gastroenterol. 91 (7): 1309–11. PMID 8677984.
- ↑ Babb RR. Radiation proctitis: a review. Am J Gastroenterol. 1996 Jul;91(7):1309-11. Review. PMID 8677984