Radiation proctitis: Difference between revisions
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'''Radiation proctitis''' (and the related '''radiation colitis''') is [[inflammation]] and damage to the lower parts of the [[Colon (anatomy)|colon]] after exposure to [[x-ray]]s or other [[ionizing radiation]] as a part of [[radiation therapy]]. Radiation proctitis most commonly occurs after treatment for [[cancer]]s such as [[cervical cancer]], [[prostate cancer]], and [[colon cancer]]. Radiation proctitis involves the lower [[intestine]], primarily the [[sigmoid colon]] and the [[rectum]]. Radiation proctitis can occur at two times after treatment: | '''Radiation proctitis''' (and the related '''radiation colitis''') is [[inflammation]] and damage to the lower parts of the [[Colon (anatomy)|colon]] after exposure to [[x-ray]]s or other [[ionizing radiation]] as a part of [[radiation therapy]]. Radiation proctitis most commonly occurs after treatment for [[cancer]]s such as [[cervical cancer]], [[prostate cancer]], and [[colon cancer]]. Radiation proctitis involves the lower [[intestine]], primarily the [[sigmoid colon]] and the [[rectum]]. Radiation proctitis can occur at two times after treatment: | ||
===Acute radiation proctitis=== | ==Classification== | ||
a. Acute radiation proctitis | |||
b. Chronic radiation proctitis | |||
==Diagnosis== | |||
===Symptoms=== | |||
====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==== | ||
[[Image:Radiation proctitis APC.jpg| | [[Image:Radiation proctitis APC.jpg|center|thumb|200px|[[Colonoscopy|Endoscopic]] image of radiation proctitis before and after therapy with [[argon plasma coagulation]].]] | ||
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]]. Connections [[fistulae]] may also develop between the colon and other parts of the body such as the [[skin]] or [[urinary system]]. Chronic radiation proctitis occurs in part because of damage to the [[blood vessel]]s which supply the colon. The colon is therefore deprived of [[oxygen]] and necessary [[nutrient]]s. Symptoms such as diarrhea and painful defectation may be treated with oral [[opioids]] and stool softeners, respectively. Complications such as obstruction and fistulae may require [[surgery]]. Several other methods are under development as of 2005 to lessen the effects of radiation proctitis. These include [[sucralfate]], [[hyperbaric oxygen therapy]], [[corticosteroid]]s, [[metronidazole]], and [[argon plasma coagulation]]. | 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]]. Connections [[fistulae]] may also develop between the colon and other parts of the body such as the [[skin]] or [[urinary system]]. Chronic radiation proctitis occurs in part because of damage to the [[blood vessel]]s which supply the colon. The colon is therefore deprived of [[oxygen]] and necessary [[nutrient]]s. Symptoms such as diarrhea and painful defectation may be treated with oral [[opioids]] and stool softeners, respectively. Complications such as obstruction and fistulae may require [[surgery]]. Several other methods are under development as of 2005 to lessen the effects of radiation proctitis. These include [[sucralfate]], [[hyperbaric oxygen therapy]], [[corticosteroid]]s, [[metronidazole]], and [[argon plasma coagulation]]. | ||
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[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||
[[Category:Radiation oncology]] | [[Category:Radiation oncology]] | ||
[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||
[[Category:Needs patient information]] | [[Category:Needs patient information]] | ||
Revision as of 16:51, 5 September 2012
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Radiation proctitis (and the related radiation colitis) is inflammation and damage to the lower parts of the colon after exposure to x-rays or other ionizing radiation as a part of radiation therapy. Radiation proctitis most commonly occurs after treatment for cancers such as cervical cancer, prostate cancer, and colon cancer. Radiation proctitis involves the lower intestine, primarily the sigmoid colon and the rectum. Radiation proctitis can occur at two times after treatment:
Classification
a. Acute radiation proctitis b. Chronic radiation proctitis
Diagnosis
Symptoms
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. [1]
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. Connections fistulae may also develop between the colon and other parts of the body such as the skin or urinary system. Chronic radiation proctitis occurs in part because of damage to the blood vessels which supply the colon. The colon is therefore deprived of oxygen and necessary nutrients. Symptoms such as diarrhea and painful defectation may be treated with oral opioids and stool softeners, respectively. Complications such as obstruction and fistulae may require surgery. Several other methods are under development as of 2005 to lessen the effects of radiation proctitis. These include sucralfate, hyperbaric oxygen therapy, corticosteroids, metronidazole, and argon plasma coagulation.
References
- ↑ Babb RR. Radiation proctitis: a review. Am J Gastroenterol. 1996 Jul;91(7):1309-11. Review. PMID 8677984