Skip to main content

Advertisement

SpringerLink
Log in

Radiation-induced proctitis

  • Published:
Current Treatment Options in Gastroenterology Aims and scope Submit manuscript

Opinion Statement

The incidence of chronic, radiation-induced proctitis is between 2% and 5 %. There is not a direct relationship between the incidence of acute radiation proctitis and the subsequent development of chronic proctitis. The treatment for this condition should proceed in a step-wise fashion from conservative therapy such as antidiarrhea medication, topical steroids, sucralfate enemas, and iron replacement to more aggressive treatment in those who do not respond. In the case of persistent rectal bleeding, laser therapy and formalin instillation should be tried prior to surgical intervention. If surgery is necessary, a transverse or descending colostomy should be tried. Aggressive surgery such as rectal resection and colo-anal anastomosis is associated with significant morbidity and mortality and should be reserved as a last resort measure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Gilinsky NH, Burns DG, Barbezat GO, Levin W, et al.: The natural history of radiation-induced proctosigmoiditis: an analysis of 88 patients. QJ Med 1983, 205:40–53.

    Google Scholar 

  2. Allen-Mersh TG, Wilson EJ, Hope-Stone HF, Mann CV: The management of late radiation-induced rectal injury after treatment of carcinoma of the uterus. Surg Gynecol Obstet 1987, 164:521–524.

    PubMed  CAS  Google Scholar 

  3. Jao SW, Bearl RW, Gunderson LL: Surgical treatment of radiation injuries of the colon and rectum. Am J Surg 1986, 151:272–277.

    Article  PubMed  CAS  Google Scholar 

  4. Saclarides TJ, King DG, Franklin JL, Doolas A: Formalin instillation for refractory radiation-induced hemorrhagic proctitis. Dis Colon Rectum 1996, 39:196–199.

    Article  PubMed  CAS  Google Scholar 

  5. Leibel SA, Phillips TL: Rectal Cancer. In Textbook of Radiation Oncology. Philadelphia: WB Saunders; 1998:677–701.

    Google Scholar 

  6. Perez C, Brady L: Late Effects of Cancer Treatment. In Principles and Practice of Radiation Oncology. Philadelphia: WB Saunders; 1998:155–211.

    Google Scholar 

  7. Choon Seng Woo T, Joseph D, Oxer H, et al.: Hyperbaric oxygen treatment for radiation proctitis. Int J Radiat Oncol Biol Phys 1997, 38:619–622.

    Article  Google Scholar 

  8. Taylor JG, DiSario JA, Buchi KN: Argon laser therapy for hemorrhagic radiation proctitis: long-term results. Gastrointest Endosc 1993, 39:641–643.

    Article  PubMed  CAS  Google Scholar 

  9. Green N, Goldberg H, Goldman H, Lombardo L, et al.: Severe rectal injury following radiation for prostatic cancer. J Urol 1983, 131:701–704.

    Google Scholar 

  10. Perez C, Fox S, Lockett MA, et al.: Impact of dose on outcome of irradiation alone in carcinoma of the uterine cervix: analysis of two different methods. Int J Radiat Oncol Biol Phys 1991, 21:885.

    PubMed  CAS  Google Scholar 

  11. Babb RR: Radiation proctitis: a review. Am J Gastroenterol 1996, 91:1309–1311. A very brief but concise review of the subject that gives a nice overview of radiation-induced proctitis.

    PubMed  CAS  Google Scholar 

  12. Roswit B, Malsky SJ, Reid CB: Severe radiation injuries of the stomach, small intestine, colon and rectum. Radiation Injuries of Gastrointestinal Tract 1972, 114:460–475.

    CAS  Google Scholar 

  13. Varma JS, Smith AN, Busuttil A: Correlation of clinical and manometric abnormalities of rectal function following chronic radiation injury. Br J Surg 1985, 72:875.

    Article  PubMed  CAS  Google Scholar 

  14. Cho KH, Lee CK, Levitt DH: Proctitis after conventional external radiation therapy for prostate cancer: importance of minimizing posterior rectal dose. Radiology 1995, 195:699–703.

    PubMed  CAS  Google Scholar 

  15. Lee WR, Hanks GE, Hanlon AL, et al.: Lateral rectal shielding reduces late rectal morbidity following high dose three-dimensional conformal radiation therapy for clinically localized prostate cancer: further evidence for a significant dose effect. Int J of Radiat Oncol Biol Phys 1996, 35:251–257.

    Article  CAS  Google Scholar 

  16. Baum CA, Biddle WL, Miner PB Jr: Failure of 5-aminosalicylic acid enemas to improve chronic radiation proctitis. Dig Dis Sci 1989, 34:758–760.

    Article  PubMed  CAS  Google Scholar 

  17. Grigsby PW, Pilepich MV, Parsons CL. Preliminary results of a phase I/II study of sodium pentosanpolysulfate in the treatment of chronic radiation-induced proctitis. Am J Clin Oncol(CCT) 1990, 13:28–31.

    CAS  Google Scholar 

  18. O’Connor J: Argon laser treatment of radiation proctitis. Arch Surgery 1989, 124:749.

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiation Oncology-M2, Henry Ford Health Sciences Center, 2799 West Grand Boulevard, 48202, Detroit, MI

    Munther Ajlouni MD

Authors
  1. Munther Ajlouni MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ajlouni, M. Radiation-induced proctitis. Curr Treat Options Gastro 2, 20–26 (1999). https://doi.org/10.1007/s11938-999-0014-5

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11938-999-0014-5

Keywords

Search

Navigation