Radiation Enteritis

Question 1

What is it?

Answer 1

Radiation of >40 Gy which damages intestine causing muscle atrophy, ulcerative changes due to ischaemia and obstruction because of radiation induced fibrotic strictures

Question 2

Who gets it?

Answer 2

People with radiation exposure

Question 3

How does it present at the time of radiation?

Answer 3

• Nausea
• Vomiting
• Diarrhoea
• Abdominal pain

This all should improve within 6 weeks after therapy is complete

Question 4

How does chronic radiation enteritis present?

Answer 4

• Abdominal pain due to obstruction
• Malabsorption : bacterial overgrowth in dilated segments and mucosal damage
• Increased bowel frequency

Question 5

How does acute radiation enteritis present?

Answer 5

Diarrhoea
Tenesmus
Sometimes blood in the stool
After the acute phase heals mucosal telangiectasias form which can cause persistent bleeding

Question 6

How is it diagnosed?

Answer 6

Chronic radiation enteritis (if symptoms persist over 3 months)

Question 7

How is it chronic radiation enteritis treated?

Answer 7

• Symptomatic management (often unsuccessful)

- Surgery (reserved for obstruction and perforation)

Question 8

How is acute radiation enteritis treated?

Answer 8

• Steroids- initially help
• Resistant anaemia treated with argon plasma coagulation
• Packing the rectum with formalin-soaked swab for 2 minutes to destroy the telangiectases