Radiation proctitis overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
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Overview
Radiation proctitis 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.
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Radiation proctitis overview from Other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications, and Prognosis
Natural History
Complications
Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Patients with radiation proctitis may appear pale and dehydrated. Some patients may appear fatigued and in distress, associated with abdominal pain.
Laboratory Findings
The laboratory findings in a patient with acute radiation proctitis can be within reference range however, in case of chronic injury anemia, elevated white blood cell, deranged LFTs and electrolyte abnormalities can be seen.
Imaging Findings
Barium studies can be done in patients who have obstructive symptoms or those suspected of having fistulas.
Other Diagnostic Studies
Other diagnostic studies such as colonoscopy, tissue biopsy and histological analysis can help with the diagnosis of radiation proctitis.
Treatment
Medical Therapy
Acute radiation proctitis is a self limiting condition and treated conservatively however in 20% of cases undergoing external beam radiation will require short interruptions in their treatment to improve symptoms.In case of chronic radiation proctitis treatment usually depends upon the severity and pattern of the symptoms.
Surgery
Surgery is not the first-line treatment option for patients with radiation proctitis.However it is usually reserved as a last resort for patients with refractory symptoms and complications.
Prevention
Primary prevention of radiation proctitis can be done by the modifications of radiation techniques and doses or by use of prophylactic adjunct medical and surgical therapies.