Materiały źródłowe

• #1 Radiation Enteritis: Treatment & Management

  https://my.clevelandclinic.org/health/diseases/22846-radiation-enteritis

  Radiation enteritis happens when radiation damages sensitive tissue in your intestines. It may occur during treatment or months after you’re finished. Some people experience mild symptoms, while others have long-lasting discomfort and complications. […] Radiation enteritis is a condition that occurs when radiation therapy causes damage to your intestines. […] Acute radiation enteritis occurs while you’re undergoing radiation therapy. Symptoms typically go away in a few weeks. […] Chronic radiation enteritis develops months to years after completing treatment. Symptoms stay with you for a long time and can lead to complications. […] Treatment typically requires regular exposure to radioactive substances for several weeks. When radiation reaches healthy cells, it causes inflammation and tissue damage.

• #2 Radiation Enteritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK526032/

  Radiation enteritis is damage to the small and/or large intestines secondary to radiation. This activity reviews the evaluation and management of radiation enteritis and highlights the role of the interprofessional team in caring for affected patients. […] The care of patients with radiation enteritis is interprofessional. Besides the surgeon, radiation oncologist, gastroenterologist, and radiologist, the nurse and dietitian is a vital member of the team. […] The patient should be educated about the potential complications and the need for repeat surgery. […] After surgery, routine surgical complications like deep vein thrombosis and atelectasis should be prevented with prophylactic treatment with LWMH and the use of the incentive spirometer, respectively. […] The quality of life for patients who suffer from complications of radiation enteritis is poor.

• #3 Enteritis (Inflammation of the Small Intestine): Definition, Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/23049-enteritis-inflammation-small-intestine

  Radiation enteritis, also called secondary inflammatory enteritis, is caused by radiation exposure, particularly to the abdominal and pelvic areas. Radiation therapy and chemotherapy are used to kill cancer cells, but they can also kill healthy cells in the protective lining of your mouth, stomach and intestines. This destroys the protective lining, leading to irritation and inflammation. […] For most people, radiation enteritis lasts only a few weeks after treatment. But occasionally, in some people, it persists for months or even years. Scientists don’t know why this occurs. People with chronic radiation enteritis may be at risk of serious damage to their small intestine. […] Treatment for enteritis is focused on managing symptoms. Rest and rehydration are usually enough. If the cause is radiation, your healthcare provider will discontinue your radiation therapy either temporarily or permanently.

• #4 Diagnosis and management of chronic radiation enteritis – UpToDate

  https://www.uptodate.com/contents/diagnosis-and-management-of-chronic-radiation-enteritis

  INTRODUCTION […] Injury to the intestines can occur following radiation therapy for cancer. It can affect both the large and small intestines, is often progressive, and may lead to a variety of clinical consequences depending upon the extent of the injury. It usually develops three or more months after radiation therapy. Chronic radiation enteritis is due to an obliterative arteritis that leads to intestinal ischemia, which can result in stricture, ulceration, fibrosis, and occasionally fistula formation. The physiologic consequences can include altered intestinal transit, reduced bile acid absorption, increased intestinal permeability, bacterial overgrowth, and lactose malabsorption. Clinical manifestations include nausea, vomiting, abdominal pain, diarrhea, weight loss, malnutrition, and bleeding (usually in patients with colonic involvement).

• #5 Radiation Enteritis – MD Searchlight

  https://mdsearchlight.com/gut-health/radiation-enteritis/?utm_source=pubmedlink&utm_campaign=MDS&utm_content=28177

  Radiation enteritis is a condition where the small and/or large intestines get damaged due to radiation exposure. […] Radiation enteritis is a common but unpredictable side effect of radiation therapy. […] Radiation enteritis is fairly widespread, resulting in lasting changes in bowel habits for around 90% of people who undergo pelvic radiotherapy. […] Diarrhea is the most common symptom of this condition, and it can occur with or without abdominal pain. […] If you have symptoms like diarrhea, stomach pain, or a feeling of fullness, your doctor may recommend a breath test. […] Acute radiation enteritis refers to inflammation and damage to the intestines caused by radiation exposure. Its symptoms are usually temporary and can often improve within weeks by drinking lots of fluids and taking medication to treat the diarrhea caused by the condition.

• #6 Enteritis: Causes, Prevention, and More

  https://www.verywellhealth.com/enteritis-5218257

  Radiation treatment for cancer can also lead to inflammation in the digestive system. […] The risk of having radiation enteritis increases with higher doses of radiation, a large treatment area, previous abdominal surgery, or having a diagnosis of diabetes or hypertension. […] For those who have radiation treatment in the abdomen or pelvis, up to 90% will experience a change in their bowel habits. It’s estimated that about 15% will have chronic issues. […] Radiation therapy for cancers that occur in the pelvis, abdomen, or colon may cause radiation enteritis. This is usually an acute issue, but it can become a chronic problem. […] Treatment for radiation enteritis is usually focused on the symptoms. Diarrhea might be treated with antidiarrheal medications. Fluids and nutrition may be given through intravenous lines in the case of dehydration or malnutrition.

• #7 Gastrointestinal Complications (PDQ®) – NCI

  https://www.cancer.gov/about-cancer/treatment/side-effects/constipation/gi-complications-hp-pdq

  Radiation enteritis is a functional disorder of the large and small bowel that occurs during or after a course of radiation therapy to the abdomen, pelvis, or rectum. […] Almost all patients undergoing radiation to the abdomen, pelvis, or rectum will show signs of acute enteritis. […] Chronic radiation enteritis may present months to years after the completion of therapy, or it may begin as acute enteritis and persist after treatment ends. […] The large and small bowel are sensitive to ionizing radiation. […] Acute enteritis occurs during or within 3 months after irradiation, with the greatest prevalence during the fourth and fifth weeks. […] Medical management includes treating diarrhea, dehydration, malabsorption, and abdominal or rectal discomfort. […] Damage to the intestinal villi from radiation therapy results in a reduction or loss of enzymes, such as lactase.

• #8 Radiation Enteritis – Symptoms, Causes And Treatment

  https://www.apollohospitals.com/diseases-and-conditions/radiation-enteritis/

  Radiation therapy is used widely to treat cancer, but it has side effects such as Radiation enteritis. Radiation enteritis is usually temporary and the inflammation usually subsides eventually, after treatment ends. […] Cancer radiation therapy leads to inflammation in your small and large intestines during radiation for cancers of the abdomen and pelvis. Radiation enteritis can result in the loss of intestinal cells as well as tissues. […] Radiation enteritis is classified into two types: acute and chronic. Acute enteritis occurs when you are undergoing radiation therapy. The condition will continue for around eight weeks following the radiation session. Chronic enteritis can produce symptoms that continue for months or years after your radiation therapy is completed. […] Doctors frequently advise patients suffering from radiation enteritis to adopt dietary modifications. These modifications are intended to alleviate stomach discomfort.

• #9 Radiation Enteritis | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/117441/all/Radiation_Enteritis

  Radiation enteritis (RE) is an inflammatory injury to the large and small intestines resulting from radiation therapy (RT). […] Acute RE develops within hours to days of RT. It usually resolves within 2 to 6 weeks after the last treatment. […] Chronic RE is usually progressive with potentially significant long-term morbidity and mortality. […] Therapeutic options for chronic RE are limited. […] Surgical resection has a role in selected cases. […] Physical measures include a belly board device to reduce volume delivered to organs during abdominal and pelvic radiation. […] Broad-spectrum antibiotics may help in cases of confirmed bacterial overgrowth. Patients undergoing RT often become immunocompromised. […] Cysteine, L-carnitine, amifostine, octreotide are being explored as preventive for both acute and chronic RE through antioxidant properties.

• #10 Gastrointestinal Complications (PDQ®): Supportive care – Health Professional Information [NCI] | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.gastrointestinal-complications-pdq%C2%AE-supportive-care-health-professional-information-nci.ncicdr0000062736

  Radiation enteritis is a functional disorder of the large and small bowel that occurs during or after a course of radiation therapy to the abdomen, pelvis, or rectum. […] Almost all patients undergoing radiation to the abdomen, pelvis, or rectum will show signs of acute enteritis. Injuries are clinically evident during or within 3 months after irradiation, with the greatest prevalence during the fourth and fifth weeks. […] Chronic radiation enteritis may present months to years after the completion of therapy, or it may begin as acute enteritis and persist after treatment ends. Only 10% to 20% of people treated with radiation to the abdomen develop chronic problems. […] Factors that influence the occurrence and severity of radiation enteritis include the following: Dose and fractionation of radiation, modality of radiation, tumor size and extent, volume of normal bowel treated, concomitant chemotherapy, and individual patient variables (e.g., previous abdominal or pelvic surgery, hypertension, diabetes mellitus, smoking, inadequate nutrition).

• #11 Gastrointestinal Complications (PDQ®) – NCI

  https://www.cancer.gov/about-cancer/treatment/side-effects/constipation/gi-complications-hp-pdq

  Only 10% to 20% of patients who receive abdominal or pelvic irradiation develop chronic radiation enteritis. […] The diagnosis of chronic radiation enteritis may be difficult to make. […] Treatment techniques that can minimize the risk of severe radiation enteritis include the use of a three- or four-field technique to minimize the amount of small bowel exposed to treatment.

• #12 Diagnosis and management of chronic radiation enteritis – UpToDate

  https://www.uptodate.com/contents/diagnosis-and-management-of-chronic-radiation-enteritis/print

  Injury to the intestines can occur following radiation therapy for cancer. It can affect both the large and small intestines, is often progressive, and may lead to a variety of clinical consequences depending upon the extent of the injury. It usually develops three or more months after radiation therapy. Chronic radiation enteritis is due to an obliterative arteritis that leads to intestinal ischemia, which can result in stricture, ulceration, fibrosis, and occasionally fistula formation. The physiologic consequences can include altered intestinal transit, reduced bile acid absorption, increased intestinal permeability, bacterial overgrowth, and lactose malabsorption. Clinical manifestations include nausea, vomiting, abdominal pain, diarrhea, weight loss, malnutrition, and bleeding (usually in patients with colonic involvement).

• #13 Gastrointestinal Complications (PDQ®): Supportive care – Health Professional Information [NCI] – Health Information Library | PeaceHealth

  https://www.peacehealth.org/medical-topics/id/ncicdr0000062736

  Radiation enteritis is a functional disorder of the large and small bowel that occurs during or after a course of radiation therapy to the abdomen, pelvis, or rectum. […] Almost all patients undergoing radiation to the abdomen, pelvis, or rectum will show signs of acute enteritis. Injuries are clinically evident during or within 3 months after irradiation, with the greatest prevalence during the fourth and fifth weeks. […] Chronic radiation enteritis may present months to years after the completion of therapy, or it may begin as acute enteritis and persist after treatment ends. Only 10% to 20% of people treated with radiation to the abdomen develop chronic problems. […] Acute side effects to the intestines occur with an exposure of approximately 10 Gy. Because curative radiation doses for many abdominal or pelvic tumors range between 25 and 76 Gy, enteritis is likely to occur.

• #14 Gastrointestinal Complications of Cancer | UCSF Department of Surgery

  https://colorectalsurgery.ucsf.edu/condition/gastrointestinal-complications-cancer

  Radiation enteritis is inflammation of the intestine caused by radiation therapy. […] The total dose of radiation and other factors affect the risk of radiation enteritis. […] Acute and chronic radiation enteritis have similar symptoms. […] Assessment of radiation enteritis includes a physical exam and health history. […] Treatment of acute radiation enteritis includes treating the symptoms. […] Treatment of chronic radiation enteritis may include the same treatments for acute radiation enteritis. […] Radiation enteritis is a condition in which the lining of the intestine becomes swollen and inflamed during or after radiation therapy to the abdomen, pelvis, or rectum. […] The larger the dose of radiation, the more damage may be done to normal tissue. […] Acute radiation enteritis occurs during radiation therapy or within three months after finishing radiation therapy.

• #15 Radiation Enteritis: Treatment & Management

  https://my.clevelandclinic.org/health/diseases/22846-radiation-enteritis

  Symptoms may include abdominal pain and cramping, bloated stomach, diarrhea, loss of appetite, nausea and vomiting, pain when you poop, rectal bleeding or pain, unintended weight loss, and urgent need to poop. […] Ongoing irritation and inflammation in your intestines can lead to dehydration, electrolyte imbalances, fistula, intestinal perforation, malabsorption, small bowel obstruction, stricture, and ulcers. […] It might not be possible to repair chronic intestinal cell damage from radiation exposure. But medical management of radiation enteritis can help you stay comfortable and avoid complications. […] Your care may include antibiotics if there are too many bacteria in your intestines, antidiarrheals, corticosteroids to quiet inflammation in your intestines, and pain relievers. […] There are steps your care team can take to protect your intestines during radiation therapy. These include custom positioning devices, modern treatments like intensity-modulated radiation therapy (IMRT), and protective shields for your bowel or rectum.

• #16 Enteritis – Side effects of mesothelioma radiation treatment

  https://www.mesothelioma-aid.org/enteritis.htm

  Mesothelioma radiation therapy stops the growth of rapidly dividing cells, such as mesothelioma cancer cells. […] Since normal cells in the lining of the bowel also divide rapidly, radiation treatment can stop those cells from growing, making it difficult for bowel tissue to repair itself. […] As bowel cells die and are not replaced, gastrointestinal problems develop over the next few days and weeks. […] Patients with acute enteritis may have the following symptoms: Nausea, Vomiting, Abdominal cramps, Frequent urges to have a bowel movement, Rectal pain, bleeding, or mucus-like discharge, Watery diarrhea. […] Symptoms of acute enteritis usually get better 2 to 3 weeks after treatment ends. […] Treatment of acute enteritis includes treating the diarrhea, loss of fluids, poor absorption, and stomach or rectal pain.

• #17 Gastrointestinal Complications of Cancer | UCSF Department of Surgery

  https://colorectalsurgery.ucsf.edu/condition/gastrointestinal-complications-cancer

  Chronic radiation enteritis may appear months after radiation therapy ends. […] About 10% to 20% of people treated with radiation to the abdomen will have chronic problems. […] People with acute radiation enteritis may have the following symptoms: nausea, vomiting, abdominal cramps, frequent urges to have a bowel movement, rectal pain, bleeding, or mucus in the stool, watery diarrhea, feeling very tired. […] Symptoms of acute enteritis usually go away 2 to 3 weeks after treatment ends. […] Symptoms of chronic radiation enteritis usually appear 6 to 18 months after radiation therapy ends. […] A doctor will do a physical exam and ask questions about the usual pattern of bowel movements, pattern of diarrhea, nutrition health, stress levels and ability to cope, and changes in lifestyle caused by the enteritis.

• #18 Gastrointestinal Complications (PDQ®): Supportive care – Health Professional Information [NCI] | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.gastrointestinal-complications-pdq%C2%AE-supportive-care-health-professional-information-nci.ncicdr0000062736

  Acute enteritis occurs during or within 3 months after irradiation, with the greatest prevalence during the fourth and fifth weeks. Acute enteritis symptoms usually resolve 2 to 3 weeks after the completion of treatment, and the mucosa may appear nearly normal. […] Medical management includes treating diarrhea, dehydration, malabsorption, and abdominal or rectal discomfort. Symptoms usually resolve with medications, dietary changes, and rest. If symptoms become severe despite these measures, a treatment break may be warranted. […] Damage to the intestinal villi from radiation therapy results in a reduction or loss of enzymes, such as lactase. […] Only 10% to 20% of patients who receive abdominal or pelvic irradiation develop chronic radiation enteritis. Signs and symptoms include colicky abdominal pain, bloody diarrhea, steatorrhea, weight loss, nausea and vomiting. […] The diagnosis of chronic radiation enteritis may be difficult to make. Clinically and radiologically recurrent tumor needs to be ruled out.

• #19 Radiation Enteritis – MD Searchlight

  https://mdsearchlight.com/gut-health/radiation-enteritis/?utm_source=pubmedlink&utm_campaign=MDS&utm_content=28177

  To manage bacterial overgrowth in the gut, which can sometimes follow acute radiation enteritis, doctors usually prescribe oral antibiotics. […] In the case of radiation proctitis and tenesmus inflammation and discomfort in the rectum and difficulty in passing stool respectively treatment often includes enemas, such as a sucralfate enema which can help to soothe and protect the lining of the intestines. […] Long term exposure to radiation can sometimes lead to serious complications like intestinal strictures (narrowing), fistulas (abnormal connections between organs), and perforations (holes) in the intestines, which usually require surgical intervention. […] Surgery for treating radiation enteritis is considered high risk. […] Patients should make sure to drink plenty of fluids and steer clear of foods that make them uncomfortable.

• #20 Radiation Enteritis and Proctitis Treatment & Management: Approach Considerations, Medical Therapy, General Principles of Surgical Management

  https://emedicine.medscape.com/article/197483-treatment

  Obstruction is the most common chronic complication affecting the irradiated small bowel. In patients with chronic radiation enteritis who require surgical intervention, 75-80% require treatment of an obstruction. […] Fistulas account for 5-10% of irradiated bowel complications that necessitate surgery. […] Hemorrhage rarely requires surgical intervention. An area of uncontrolled bleeding that can be localized within the small bowel but cannot be treated conservatively may necessitate surgical resection of the involved bowel segment. […] In low-risk patients, rectal strictures and fistulas are best treated with proctectomy with reconstruction. […] A proximal diverting colostomy may be created if healing of the anastomosis is a concern. […] Patients who are not candidates for extensive resection procedures benefit from undergoing a proximal diverting colostomy.

• #21 HIE Multimedia – Radiation enteritis

  https://adamcertificationdemo.adam.com/content.aspx?productid=117&isarticlelink=false&pid=1&gid=000300

  Your provider may choose to decrease your radiation for a short period of time. […] There often are no good treatments for chronic radiation enteritis that is more severe. […] Complications may include: Bleeding and anemia; Dehydration; Iron deficiency; Malabsorption; Malnutrition; Weight loss. […] Contact your provider if you are having radiation therapy or have had it in the past and are having a lot of diarrhea or stomach pain and cramping.

• #21 HIE Multimedia – Radiation enteritis

  https://adamcertificationdemo.adam.com/content.aspx?productid=117&isarticlelink=false&pid=1&gid=000300

  Radiation enteritis is damage to the lining of the intestines (bowels) caused by radiation therapy, which is used for some types of cancer treatment. […] Starting a low-fiber diet on the first day of radiation treatment may help you avoid problems. The best choice of foods depends on your symptoms. […] Your provider may have you use certain medicines such as: Medicines that help decrease diarrhea, such as loperamide; Pain medicines; Steroid foam that coats the lining of the rectum; Special enzymes to replace enzymes from the pancreas; Oral 5-aminosalicylates or metronidazole; Rectal installation with hydrocortisone, sucralfate, 5-aminosalicylates. […] Other things you can do include: Eat foods at room temperature; Eat small meals more often; Drink plenty of fluids, up to 12 8-ounce (240 milliliter) glasses every day when you have diarrhea. Some people will need fluids given through a vein (intravenous fluids).

• #22 Diagnosis and management of chronic radiation enteritis – UpToDate

  https://www.uptodate.com/contents/diagnosis-and-management-of-chronic-radiation-enteritis/print

  The diagnosis of chronic radiation enteritis is suspected in patients with nausea, vomiting, abdominal pain, diarrhea, or lower gastrointestinal bleeding three or more months after completion of radiation therapy. The diagnosis is usually established by segmental bowel inflammation in regions of a known radiation field on imaging or by endoscopy and histology. […] Evaluation of a patient with suspected chronic radiation enteritis serves to exclude other causes of etiologies, establish the diagnosis of chronic radiation, and determine the extent of the disease. […] The patient’s prior radiation treatment should be reviewed to determine the cumulative dose, dose per fraction, proximity of sensitive tissues and organs, and other cancer treatments (eg, abdominal surgery, concurrent chemotherapy) that can increase the risk of radiation enteritis. This may help to determine which intestinal segments may have received excessive radiation exposure, which can then be correlated with the radiologic findings and the clinical presentation.

• #23 Diagnosis and management of chronic radiation enteritis – UpToDate

  https://www.uptodate.com/contents/diagnosis-and-management-of-chronic-radiation-enteritis

  This topic review will focus on the diagnosis and management of chronic radiation injury to the small intestine and proximal colon. […] […] DIAGNOSIS […] The diagnosis of chronic radiation enteritis is suspected in patients with nausea, vomiting, abdominal pain, diarrhea, or lower gastrointestinal bleeding three or more months after completion of radiation therapy. The diagnosis is usually established by segmental bowel inflammation in regions of a known radiation field on imaging or by endoscopy and histology. […] Diagnostic approach — Evaluation of a patient with suspected chronic radiation enteritis serves to exclude other causes of etiologies, establish the diagnosis of chronic radiation, and determine the extent of the disease. […] The patient’s prior radiation treatment should be reviewed to determine the cumulative dose, dose per fraction, proximity of sensitive tissues and organs, and other cancer treatments (eg, abdominal surgery, concurrent chemotherapy) that can increase the risk of radiation enteritis. This may help to determine which intestinal segments may have received excessive radiation exposure, which can then be correlated with the radiologic findings and the clinical presentation.

• #24 Radiation-induced enteritis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/radiation-induced-enteritis-1?lang=us

  Radiation-induced enteritis is a small bowel pathology resulting from toxic effects of radiotherapy on the small bowel wall and vasculature. […] The clinical presentation is non-specific with abdominal pain, vomiting, bloody diarrhea and steatorrhea. Patients with chronic radiation enteritis may develop deficiencies of calcium, iron and vitamin B12 deficiency. […] In the acute phase, radiation affects bowel mucosa causing cell death with ulceration. It also causes inflammation with mucosal and submucosal edema. In the subacute and chronic phases healing and fibrosis occurs. Additionally, radiation induces endarteritis obliterans, which results in a state of chronic mesenteric ischemia leading to bowel strictures. […] Following pelvic radiotherapy, enteritis of the small bowel typically involves the more fixed terminal ileum and manifests as bowel wall thickening and submucosal edema at CT. […] Complications of abdominopelvic radiation therapy include radiation-induced enteritis.

• #25 Radiation enteritis – Care at Mayo Clinic – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/radiation-enteritis/care-at-mayo-clinic/mac-20355412

  Mayo Clinic experts work as a team to provide whole-person care to those with radiation enteritis. […] If you experience symptoms of radiation enteritis, your health care provider may recommend: Anti-diarrheal medications, Dietary changes, such as reducing your intake of dairy products, fatty foods and high-fiber foods, Pain medications to relieve pain of inflammation. […] Radiation enteritis that persists after treatment or that develops months or years after treatment is called chronic radiation enteritis. Treatment for chronic radiation enteritis is similar to treatments used for temporary radiation enteritis but may also include: Nutritional support, Antibiotics, Surgery. […] The range of treatments offered to people with radiation enteritis includes supportive care to treat symptoms, surgery to remove a portion of the intestine and a variety of options to improve nutrition while your intestine heals. […] At Mayo Clinic, gastroenterologists, general surgeons and radiologists work as a multidisciplinary team to care for people with radiation enteritis.

• #26 Bowel Problems | Radiation Therapy Side Effects | Cancer Council NSW

  https://www.cancercouncil.com.au/cancer-information/cancer-treatment/radiation-therapy/side-effects/bowel-problems/

  Ask your doctor about suitable medicines for diarrhoea. Take as directed. […] Check with your treatment team before taking any over-the-counter or home remedies, as taking them with anti-diarrhoea medicines may cause side effects. […] Contact your treatment team immediately if there is blood in your bowel motions or if you have more than 5–6 bowel movements in 24 hours.

• #27 Radiation-Induced Diarrhea | Oncology Nursing Society

  https://onf.ons.org/clinical-tools/pep/radiation-induced-diarrhea

  Radiation-induced diarrhea is seen most often with radiation to abdominal and pelvic fields. […] Acute radiation enteritis can be seen in up to 70% of patients, depending on treatment and patient predisposing factors. […] Late-onset effects, manifested as chronic enteritis, can occur months or years after treatment.

• #28 Diarrhea After Radiation | OncoLink

  https://www.oncolink.org/support/side-effects/gastrointestinal-side-effects/diarrhea/diarrhea-after-radiation

  When your bowel is in the treatment area, this damage can lead to diarrhea, incontinence (not being able to hold your bowels), and urgency (needing to go right away). […] Tell your healthcare provider if you are having frequent diarrhea after having had radiation. Your provider can: […] If you are having diarrhea after radiation, you should keep a food diary. This will help to see if certain foods cause diarrhea or make it worse. […] What can I do to stop or lessen the diarrhea? […] If you are having diarrhea after radiation, make sure to speak with your provider about how you can manage it.

• #29 Radiation Enteritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/n/statpearls/article-28177/

  Radiation enteritis is damage to the small and/or large intestines secondary to radiation. This activity reviews the evaluation and management of radiation enteritis and highlights the role of the interprofessional team in caring for affected patients. […] Symptoms of acute radiation enteritis often self-resolve within weeks of supportive treatment with antimotility agents and good water intake; surgery is rarely needed. […] It is important to resect the whole irradiated bowel in the first operation to reduce the need for more surgical procedures, but it is not a suitable option in every case due to fear of complications such as short bowel syndrome. […] The care of patients with radiation enteritis is interprofessional. Besides the surgeon, radiation oncologist, gastroenterologist, and radiologist, the nurse and dietitian is a vital member of the team.

• #30 Radiation Enteritis | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/28177

  Radiation enteritis is an unavoidable side effect of radiotherapy; however, its development is highly variable. […] Diarrhea, abdominal pain, intestinal hemorrhage, intestinal obstruction, intestinal perforation, fistulas, malabsorption, rectal pain, and rectal bleeding secondary to ulceration are some of the common symptoms. […] It can be treated with supportive measures or surgically. […] The care of patients with radiation enteritis is interprofessional. Besides the surgeon, radiation oncologist, gastroenterologist, and radiologist, the nurse and dietitian is a vital member of the team. […] The patient should be educated about the potential complications and the need for repeat surgery. […] After surgery, routine surgical complications like deep vein thrombosis and atelectasis should be prevented with prophylactic treatment with LWMH and the use of the incentive spirometer, respectively. […] When surgery is performed on the radiated intestine, this carries high morbidity and mortality.

• #31 Radiation Enteritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/n/statpearls/article-28177/

  The patient should be educated about the potential complications and the need for repeat surgery. […] After surgery, routine surgical complications like deep vein thrombosis and atelectasis should be prevented with prophylactic treatment with LWMH and the use of the incentive spirometer, respectively.

• #32 Radiation enteritis: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000300.htm

  Radiation enteritis is damage to the lining of the intestines (bowels) caused by radiation therapy, which is used for some types of cancer treatment. […] Starting a low-fiber diet on the first day of radiation treatment may help you avoid problems. The best choice of foods depends on your symptoms. […] Your provider may have you use certain medicines such as: […] Other things you can do include: […] Your provider may choose to decrease your radiation for a short period of time. […] There often are no good treatments for chronic radiation enteritis that is more severe. […] Contact your provider if you are having radiation therapy or have had it in the past and are having a lot of diarrhea or stomach pain and cramping.

• #33 Managing long term radiation enteritis – Macmillan Online Community

  https://community.macmillan.org.uk/cancer_experiences/life-after-cancer-forum/f/moving_on___post_treatment-forum/226074/managing-long-term-radiation-enteritis

  I was diagnosed with radiation enteritis in April this year. […] I rang my GP and I was referred to a dietitian. I am now on a special diet. The list of foods you are allowed to have and there is also a list of foods to avoid is comprehensive. […] I would advise you to contact your GP and ask to be referred to a dietitian, plus you may need vitamins and nutritional supplements. Plus your GP may refer you to a Gastroenterologist to help you manage your symptoms. […] The dietitian will help you and will a gastroenterologist. I would also ask about treating the enteritis side of things. I am not on anything for it but I do believe there is some form of medicines but you do have to ask. […] I finished treatment 10 years ago and the symptoms have been creeping up on me over the last few years. […] The consultant radiology person said she would refer me to the gastro team if I asked, but I would rather try to manage it through diet (and loperamide) and avoid a whole raft of tests that’ll probably tell me what I already know.

• #34 Bowel Problems | Radiation Therapy Side Effects | Cancer Council NSW

  https://www.cancercouncil.com.au/cancer-information/cancer-treatment/radiation-therapy/side-effects/bowel-problems/

  If you have radiation to the pelvic area, the radiation therapists may advise you to drink fluids before each treatment. This will expand your bladder and push the bowel away from the radiation. […] Even with precautions, radiation therapy can irritate the lining of the bowel or stomach and affect the way the bowel works. These changes are usually temporary, but for some people they are permanent and can have a major impact on quality of life. It is important to talk to your treatment team if you are finding bowel issues difficult to manage. […] Rarely, after radiation therapy to the pelvis, especially if you have had previous abdominal surgery, you may develop a bowel blockage. This can be serious. It is important to let you doctor and treatment team know if you have pain in the abdomen, vomiting and difficulty opening your bowels.

• #35 Proctitis

  https://www.eviq.org.au/clinical-resources/radiation-oncology/421-management-of-radiation-induced-proctitis

  Radiation proctitis is a term used to describe radiation-induced injury to the rectal mucosa following radiation therapy to the pelvic area. Depending on the time of onset, and to a lesser extent the clinical features and histology, radiation proctitis is defined as being either acute or chronic. […] Acute radiation proctitis presents during or shortly after radiation therapy. It lasts for less than 6 months after treatment and in most cases resolves within a few weeks of finishing therapy. […] Chronic radiation proctitis can present with a range of symptoms and these will determine the choice of management strategy. The level of intervention required will depend on the severity of symptoms and the risk-benefit profile of available treatment options. Referral to a gastrointestinal specialist to guide treatment may be appropriate. […] Educate the patient about the likelihood of developing acute and/or chronic radiation-induced proctitis prior to commencement of treatment. […] Provide written material, e.g., eviQ patient information sheet diarrhoea during cancer treatment.

• #36 CE Activity | Radiation Enteritis | Nurses

  https://www.statpearls.com/nurse/ce/activity/103795/?specialty=specialty

  Radiation enteritis is damage to the small and/or large intestines secondary to radiation. Different terms like radiation colitis, radiation enteropathy, radiation mucositis, and pelvic radiation disease have been used to describe this phenomenon. […] This activity reviews the evaluation and management of radiation enteritis and highlights the role of the interprofessional team in caring for affected patients. […] At the conclusion of this activity, the learner will be better able to: […] Summarize the treatment of radiation enteritis. […] Outline how interprofessional team communication can improve outcomes for patients with radiation enteritis.

• #37 Health Information Library | Rumah Sakit Pusat Pertamina

  https://rspp.co.id/dcontent.html?id=CON-20248518&n=Radiation%20enteritis

  Radiation enteritis is inflammation of the intestines that occurs after radiation therapy. […] Treatment focuses on relieving symptoms until the inflammation heals. In severe cases, tube feeding or surgery to remove sections of the intestine may be necessary. […] Radiation enteritis treatment usually involves managing symptoms until they go away. This condition causes irritation of the intestines after radiation therapy for cancer. Your health care provider might recommend changes to your diet and medications for diarrhea and pain. Antibiotics can treat an overgrowth of bacteria. If radiation enteritis lasts longer, you might need a feeding tube. Sometimes, surgery is used to bypass the part of the intestine that’s irritated.

• #38 Radiation Enteritis and Proctitis Treatment & Management: Approach Considerations, Medical Therapy, General Principles of Surgical Management

  https://emedicine.medscape.com/article/197483-treatment

  The following medical treatments aim to control the symptoms of radiation-induced enteritis and proctitis: […] Adequate hydration […] Antidiarrheals Loperamide is a commonly used first agent; if diarrhea is not adequately controlled with the use of loperamide, octreotide at a dosage of 100 g subcutaneously (SC) twice daily has been shown to be effective; cholestyramine also decreases the frequency of diarrhea. […] Hyperbaric oxygen therapy (HBOT; considered in the treatment of intractable radiation proctitis, prior to surgical intervention). […] Surgical intervention may prevent or treat the complications of enteritis or proctitis. Preventive surgical procedures are performed in conjunction with the primary surgical procedure for cancer resection. […] Surgical procedures to treat radiation enteritis complications are selected on the basis of the extent of the involved bowel, as well as the technical feasibility of completing the procedure.

• #39 Radiation Enteritis: Symptoms, Diagnosis and Treatments

  https://www.healthline.com/health/radiation-enteritis

  Radiation enteritis can cause the loss of both intestinal cells and tissue. […] Some common treatments for enteritis include: antidiarrheal medicine, steroids, strong pain relief medicine like hydrocodone, lactose-free and low-fat diet, antibiotics to treat any excess bacteria within the intestines. […] Doctors will often suggest that people affected by radiation enteritis make changes in their diet. These changes are designed to lessen aggravation to the digestive system. […] Work with your doctor to come up with a diet plan that will help you manage your symptoms. […] Most people are able to treat enteritis with dietary changes alone. However, if there is severe damage to your intestines, you may need intestinal bypass surgery. This is a surgical procedure where the damaged parts of your intestine are removed and the healthy parts are connected. This is relatively rare.

• #40 Radiation Enteritis: Treatment & Management

  https://my.clevelandclinic.org/health/diseases/22846-radiation-enteritis

  If you have concerns about how radiation enteritis may affect your health, talk with your healthcare provider. […] Paying careful attention to your diet and fluid intake can ease discomfort and promote healing. […] If you’re experiencing symptoms of radiation enteritis, talk to your healthcare provider. Treatments can relieve discomfort and lower the risk of complications.

• #41 Gastrointestinal Complications (PDQ®): Supportive care – Health Professional Information [NCI] – Health Information Library | PeaceHealth

  https://www.peacehealth.org/medical-topics/id/ncicdr0000062736

  Medical management includes treating diarrhea, dehydration, malabsorption, and abdominal or rectal discomfort. Symptoms usually resolve with medications, dietary changes, and rest. If symptoms become severe despite these measures, a treatment break may be warranted. […] Damage to the intestinal villi from radiation therapy results in a reduction or loss of enzymes, such as lactase. […] A diet that is lactose free, low fat, and low residue can help manage symptoms. […] Foods to avoid include milk and milk products, whole-bran bread and cereal, nuts, seeds, and coconuts, fried, greasy, or fatty foods, fresh and dried fruit and some fruit juices such as prune juice, raw vegetables, rich pastries, popcorn, potato chips, and pretzels, strong spices and herbs, chocolate, coffee, tea, and soft drinks with caffeine, alcohol and tobacco.

• #42 Gastrointestinal Complications (PDQ®): Supportive care – Health Professional Information [NCI] – Health Information Library | PeaceHealth

  https://www.peacehealth.org/medical-topics/id/ncicdr0000062736

  Foods to encourage include fish, poultry, and meat that are cooked, broiled, or roasted, bananas, applesauce, peeled apples, and apple and grape juices, white bread and toast, macaroni and noodles, baked, boiled, or mashed potatoes, cooked vegetables that are mild, such as asparagus tips, green and waxed beans, carrots, spinach, and squash, mild processed cheese, eggs, smooth peanut butter, buttermilk, and yogurt. […] Surgical management of the patient’s symptoms is indicated, with surgical management reserved for severe damage.

• #43 Managing the Adverse Effects of Radiation Therapy | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/0815/p381.html

  Mild intermittent symptoms of chronic enteritis are managed with a low-residue diet, stool softeners, and loperamide (Imodium). […] Oral sulfasalazine (Azulfidine) is effective in the prevention of proctitis in all patients receiving pelvic radiation. […] Sucralfate enemas are recommended for treatment of chronic radiation-induced proctitis. […] Hyperbaric oxygen therapy significantly improved healing responses in patients with refractory radiation proctitis in a study of 120 patients (number needed to treat = 3). […] Phosphodiesterase type 5 inhibitors, such as sildenafil (Viagra) and tadalafil (Cialis), are effective for radiation-associated erectile dysfunction. […] Female sexual dysfunction is most common after radiation therapy for cervical and endometrial cancer. Adverse effects include decreased sexual interest, vaginal dryness and stenosis, dyspareunia, and general sexual dissatisfaction. […] There is some evidence to support the use of vaginal lubricating creams for vaginal irritation following radiation. […] Men and women, as well as their spouses, may benefit from counseling or referral to a sex therapist or support group.

• #44 Intestinal microecological transplantation for a patient with chronic radiation enteritis: A case report

  https://www.wjgnet.com/1007-9327/full/v30/i19/2603.htm

  Intestinal microecological transplantation is an effective treatment for relieving the clinical symptoms of chronic radiation enteritis by altering the composition of the intestinal flora. […] This study provides a new approach for treating patients with chronic radiation enteritis. […] FMT can effectively treat patients with chronic radiation enteritis by providing short-term relief and long-term symptom remission. […] This provides further evidence for the effectiveness of FMT in treating patients with chronic radiation enteritis and improving quality of life. […] Based on these findings, we recommend considering FMT as part of the treatment algorithm for chronic radiation enteritis, particularly in cases refractory to conventional therapies.

• #45 Radiation Enteritis and Proctitis Treatment & Management: Approach Considerations, Medical Therapy, General Principles of Surgical Management

  https://emedicine.medscape.com/article/197483-treatment

  Most patients initially respond well to conservative therapy; however, recurring symptoms and signs often eventually necessitate surgical intervention. Indications for surgical intervention include the following: […] To prevent radiation-induced injury to the small bowel […] To treat complications of radiation-induced injury to the small and large bowel, including perforation, obstruction (the most common presentation of chronic radiation enteritis), fistula, and bleeding (the most common presentation of chronic radiation proctitis). […] The American Society of Colon and Rectal Surgeons (ASCRS) has formulated guidelines for the treatment of chronic radiation proctitis. […] Measures designed to decrease or prevent the occurrence of radiation-induced enteropathy are an integral part of radiation therapy (RT) administration. Preventive measures include medical therapies to decrease the effects of radiation on the gastrointestinal (GI) tract.

• #46 Radiation Enteritis: Symptoms, Diagnosis and Treatments

  https://www.healthline.com/health/radiation-enteritis

  When you go through radiation treatment, your doctor will take steps to reduce the chances of enteritis. These prevention methods may include: putting your body in the best position to protect your small intestines while receiving radiation, giving radiation treatment while you have to urinate, adjusting the amount of radiation delivered, placing clips at tumor site to make sure there is a more direct radiation dose.

• #47 Gastrointestinal Complications (PDQ®) – NCI

  https://www.cancer.gov/about-cancer/treatment/side-effects/constipation/gi-complications-hp-pdq

  Only 10% to 20% of patients who receive abdominal or pelvic irradiation develop chronic radiation enteritis. […] The diagnosis of chronic radiation enteritis may be difficult to make. […] Treatment techniques that can minimize the risk of severe radiation enteritis include the use of a three- or four-field technique to minimize the amount of small bowel exposed to treatment.

• #48 Radiation-Induced Enteritis: Incidence, Mechanisms, and Management

  https://www.cancernetwork.com/view/radiation-induced-enteritis-incidence-mechanisms-and-management

  Conventional antidiarrheal agents fail to prevent the onset of grade 3/4 diarrhea. […] The role of octreotide in the prevention of grade 3 diarrhea has not been studied in patients receiving radiation therapy. Currently we are developing a randomized, placebo-controlled, phase III study through the Radiation Therapy Oncology Group (RTOG) using octreotide LAR depot for prevention or reduction in the incidence of severe diarrhea in patients receiving combined chemoradiotherapy for rectal/anal cancer. […] The above studies will provide useful information regarding the role of octreotide LAR depot in the prevention and treatment of radiation enteritis associated with pelvic radiotherapy alone or in conjunction with chemotherapy.

• #49 What Should You Know About Radiation Enteritis? Symptoms and Causes

  https://www.webmd.com/cancer/what-is-radiation-enteritis

  Radiation enteritis usually goes away on its own. But there are ways to treat and manage the condition. […] Your doctor may recommend that you take antioxidant supplements during radiotherapy to reduce side effects, such as inflammation of the intestines. […] Your doctor may recommend medications to relieve diarrhea. In some cases, you may be prescribed pain medicines. […] Yes. You can reduce your radiation enteritis symptoms and speed up your recovery if you: […] Drink plenty of water to prevent dehydration and reduce inflammation in the intestine. […] Do not use any medicine for pain relief or inflammation relief without consulting with your doctor first. If the symptoms worsen, talk to your doctor right away.

• #50 Gastrointestinal Complications of Cancer | UCSF Department of Surgery

  https://colorectalsurgery.ucsf.edu/condition/gastrointestinal-complications-cancer

  The symptoms of radiation enteritis usually get better with treatment, but if symptoms get worse, then cancer treatment may have to be stopped for a while. […] Treatment of acute radiation enteritis or the symptoms may include anti-inflammatory medicines, antibiotics, steroids, medicines to stop diarrhea, vitamin E, probiotics, and diet changes. […] Treatment of chronic radiation enteritis may include the same treatments for acute radiation enteritis.

• #51 Enteritis and cancer | EBSCO Research Starters

  https://www.ebsco.com/research-starters/health-and-medicine/enteritis-and-cancer

  In cancer patients, enteritis is caused by radiation therapy to the abdomen, pelvic area, or rectum. […] Radiation enteritis is a specific type of enteritis that occurs as a result of radiation therapy during cancer treatment. […] The cells lining both the large and small intestine tend to divide often and can be substantially damaged by exposure to radiation necessary to treat cancer occurring in the abdomen and pelvis. […] In acute radiation enteritis, the changes to the cells are reversible, and the condition usually clears up a month or two after radiation therapy stops. […] In chronic radiation enteritis, the cellular damage continues. […] Symptoms usually improve for a time, but they recur between six and eighteen months after radiation therapy has been completed. […] Damage to the intestinal lining in chronic radiation enteritis is permanent, and symptoms are difficult to control.

• #52 Reddit – The heart of the internet

  https://www.reddit.com/r/cancer/comments/pkns9l/chronic_radiation_enteritis_what_is_your/

  Good news: Dad is in remission from stomach cancer. He went through a subtotal gastrectomy, chemo, and radiation. […] The bad news: dad is suffering severe radiation damage. Constant unbearable abdominal pain, diarrhea which has forced us to keep him in the hospital to replenish fluids at least 2 weeks out of the month for the last 3 months. […] It feels like cancer treatment has been a trade for my dad, he fought cancer and won so far, but the radiation enteritis is just plainly horrible and furthers suffering. […] Does anybody have a similar experience? How have you been able to manage radiation enteritis? Really needing some light on expectations.

• #53 Radiation enteropathy – Wikipedia

  https://en.wikipedia.org/wiki/Radiation_enteropathy

  Radiation enteropathy is a syndrome that may develop following abdominal or pelvic radiation therapy for cancer. Many affected people are cancer survivors who had treatment for cervical cancer or prostate cancer. It has also been termed pelvic radiation disease with radiation proctitis being one of its principal features and radiation-induced lumbar plexopathy (RILP) being a rare consequence. […] In people presenting with symptoms compatible with radiation enteropathy, the initial step is to identify what is responsible for causing the symptoms. Management is best with a multidisciplinary team including gastroenterologists, nurses, dietitians, surgeons and others. Medical treatments include the use of hyperbaric oxygen which has beneficial effects in radiation proctitis or anal damage. Nutritional therapies include treatments directed at specific malabsorptive disorders such as low fat diets and vitamin B12 or vitamin D supplements, together with bile acid sequestrants for bile acid diarrhea and possibly antibiotics for small intestinal bacterial overgrowth. Probiotics have all been suggested as another therapeutic avenue.

• #54 Testing control of radiationinduced diarrhea with a psyllium bulking agent: A pilot study | Murphy | Canadian Oncology Nursing Journal / Revue canadienne de soins infirmiers en oncologie

  https://canadianoncologynursingjournal.com/index.php/conj/article/view/441/0

  Sixty cancer patients who were undergoing radiation therapy to the pelvis of at least 4,000 cGy in 20 fractions over four weeks were randomized to take or not take Metamucil. […] According to this pilot study, Metamucil was an effective method of controlling radiation-induced diarrhea. […] Results of this pilot study have implications for clinical practice and nursing research. […] Capirci, C., Stevanin, C., Laveder, F., Polico, C. (1993). Diet therapy: An effective method to prevent radiation enteritis.

• #55 Gastroenterologist specializing in radiation enteritis/proctitis treatments — Cancer Survivors Network

  https://csn.cancer.org/discussion/328282/gastroenterologist-specializing-in-radiation-enteritis-proctitis-treatments

  My husband recently completed RT for a biochemical recurrence of prostate cancer. He had a tough time getting through the radiation treatments due to enteritis and then proctitis that required treatments with oral steroids and a brief pause in his treatments. […] Sorry to hear your husband is suffering with what sounds like „acute” radiation proctitis. […] The „acute” proctitis is usually self limiting and can resolve with few long term issues. Hopefully this will be the case for your husband. […] Since we are all different and respond differently to treatments I would make sure to get a referral to an experienced GI doctor in your area for advice on how to proceed. […] He was told to follow low fiber during the radiation due to the radiation enteritis (diarrhea and cramping) and radiation proctitis (tenesmus, rectal pain and fecal urgency) he experienced during treatment. […] I reached out on this forum in case there was a specialist that someone knew of that had extensive experience with radiation bowel injury. […] I hope that the U Rochester gastroenterologist will provide proper guidance.

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