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Revision as of 18:29, 11 September 2012

For patient information, click here

Radiation proctitis Microchapters

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Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Radiation proctitis from other Diseases

Epidemiology and Demographics

Risk Factors

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Natural History, Complications and Prognosis

Diagnosis

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Treatment

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: Radiation colitis

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.

Classification

a. Acute radiation proctitis

b. Chronic radiation proctitis

Pathophysiology

  • Acute radiation proctitis is due to direct damage of the lining (epithelium) of the colon. [1]
  • 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.

Natural History, Complications and Prognosis

Complications

Complications such as obstruction and fistulae may require surgery.

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. [2]

Chronic radiation proctitis

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, 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.

Treatment

References

  1. Babb RR. Radiation proctitis: a review. Am J Gastroenterol. 1996 Jul;91(7):1309-11. Review. PMID 8677984
  2. Babb RR. Radiation proctitis: a review. Am J Gastroenterol. 1996 Jul;91(7):1309-11. Review. PMID 8677984

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