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'''For patient information, click [[Radiation proctitis (patient information)|here]]'''
{{Radiation proctitis}}


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{{CMG}}  {{AE}} [[User:Rekha|Rekha, M.D.]], {{MIR}}


==Overview==
{{SK}} Radiation colitis
'''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 overview|Overview]]==


==Classification==
==[[Radiation proctitis historical perspective|Historical Perspective]]==
a. Acute radiation proctitis


b. Chronic radiation proctitis
==[[Radiation proctitis classification|Classification]]==


==Pathophysiology==
==[[Radiation proctitis pathophysiology|Pathophysiology]]==
* Acute radiation proctitis 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 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.
==[[Radiation proctitis causes|Causes]]==
==Natural History, Complications and Prognosis==
 
===Complciations===
==[[Radiation proctitis differential diagnosis|Differentiating Radiation proctitis from other Diseases]]==
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.
 
==[[Radiation proctitis epidemiology and demographics|Epidemiology and Demographics]]==
 
==[[Radiation proctitis risk factors|Risk Factors]]==
 
==[[Radiation proctitis screening|Screening]]==
 
==[[Radiation proctitis natural history, complications and prognosis|Natural History, Complications and Prognosis]]==


==Diagnosis==
==Diagnosis==
===Symptoms===
[[Radiation proctitis staging|Staging]] | [[Radiation proctitis history and symptoms|History and Symptoms]] | [[Radiation proctitis physical examination|Physical Examination]] | [[Radiation proctitis laboratory findings|Laboratory Findings]] |  [[Radiation proctitis abdominal x ray|Abdominal X Ray]] | [[Radiation proctitis CT|CT]] | [[Radiation proctitis MRI|MRI]] | [[Radiation proctitis ultrasound|Ultrasound]] | [[Radiation proctitis other imaging findings|Other Imaging Findings]] | [[Radiation proctitis other diagnostic studies|Other Diagnostic Studies]]
====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>
==Treatment==
[[Radiation proctitis medical therapy|Medical Therapy]] | [[Radiation proctitis surgery|Surgery]] | [[Radiation proctitis primary prevention|Primary Prevention]] | [[Radiation proctitis secondary prevention|Secondary Prevention]] | [[Radiation proctitis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] |  [[Radiation proctitis future or investigational therapies|Future or Investigational Therapies]]


====Chronic radiation proctitis====
==Case Studies==
[[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]].


==Treatment==
[[Radiation proctitis case study one|Case #1]]
* Symptoms such as diarrhea and painful defectation may be treated with oral [[opioids]] and stool softeners, respectively.
* 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]].


== References ==
{{Reflist|2}}


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Latest revision as of 23:51, 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]

Synonyms and keywords: Radiation colitis

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Radiation proctitis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Staging | History and Symptoms | Physical Examination | Laboratory Findings | Abdominal X Ray | CT | MRI | Ultrasound | Other Imaging Findings | Other Diagnostic Studies

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