Radiation proctitis

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

Synonyms and keywords: Radiation colitis

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.

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

• 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, corticosteroids, metronidazole, and argon plasma coagulation.

References

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