Materiały źródłowe

• #1 Radiation Enteritis – StatPearls – NCBI Bookshelf

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

  Radiation enteritis can be acute or chronic. The chronic form usually develops between 3 months to 30 years after treatment. […] This activity reviews the evaluation and management of radiation enteritis and highlights the role of the interprofessional team in caring for affected patients. […] Summarize the treatment of radiation enteritis. […] Symptoms of acute radiation enteritis often self-resolve within weeks of supportive treatment with antimotility agents and good water intake; surgery is rarely needed. […] Antioxidant administration during radiotherapy has been shown to increase efficacy and decrease the side effect profile. […] Oral antibiotics are given to patients suspected of having bacterial overgrowth, along with vitamins and electrolytes replacement if needed. […] First-line treatment for radiation proctitis and tenesmus includes enemas, for example, the sucralfate enema.

• #1 Mayo Clinic Health Library – Radiation enteritis | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20248518

  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.

• #1 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. […] Radiation enteritis often is temporary. Your symptoms may subside in the weeks after your treatment ends. During this time, treatments may help relieve your symptoms. If radiation enteritis persists, other treatments may be recommended. […] 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.

• #1 Enteritis and cancer | EBSCO Research Starters

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

  Treatment focuses on symptom management, dietary modifications, and sometimes medications to control diarrhea and pain. […] Radiation enteritis is treated by managing the symptoms. Dietary changes include avoiding spicy, fatty, and high-fiber foods, alcohol, and milk products because the intestine often loses the ability to make the enzyme lactase, which is needed to digest milk. Diarrhea is treated with antidiarrheal medicines such as bismuth subsalicylate (Kaopectate), diphenoxylate and atropine (Lomotil), anhydrous morphine (Paregoric), or loperamide (Imodium). Fluid intake is increased to compensate for fluids lost with diarrhea. Antispasmodics may also be given to slow contractions in the bowel. Nutritional counseling is important, especially in chronic enteritis, because the bowel loses the ability to absorb nutrients. Nutritional supplements and digestive aids are often given. Surgery to remove the damaged portion of the bowel in chronic enteritis is controversial due to high postoperative morbidity rates. In the mid-2020s, new treatments emerged for acute and chronic enteritis, including probiotics and fecal transplant. Amino acid-based oral rehydration solution can also reverse damage to the intestines.

• #1 Radiation Enteritis: Treatment & Management

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

  Radiation enteritis is a condition that occurs when radiation therapy causes damage to your intestines. Radiation therapy uses radioactive substances to destroy abnormal cells. Its a common treatment for cancer and certain blood disorders. […] Treatment typically requires regular exposure to radioactive substances for several weeks. When radiation reaches healthy cells, it causes inflammation and tissue damage. Cells in the lining of your intestines are more sensitive to the effects of radiation. […] 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, medications that slow intestinal activity to relieve diarrhea. Corticosteroids to quiet inflammation in your intestines. Pain relievers.

• #1 Radiation enteritis: MedlinePlus Medical EncyclopediaLock

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

  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). […] 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. Medicines such as cholestyramine, diphenoxylate-atropine, loperamide, or sucralfate may help. Thermal therapy (argon laser probe, plasma coagulation, heater probe). You may need to consider surgery to either remove or go around (bypass) a section of damaged intestine.

• #1 Radiation Enteritis: Symptoms, Diagnosis and Treatments

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

  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. […] 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.

• #1 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. […] […] […] MANAGEMENT […] Approach to management […] • Dietary modification […] • Antidiarrheal agents […] • Bile acid sequestrants […] • Antibiotics […] • Surgery […] • Other

• #1

  https://journals.lww.com/ajg/fulltext/2014/10002/improvement_of_chronic_diarrhea_associated_with.1347.aspx

  Radiation enteritis is a well-described complication of pelvic or abdominal radiation therapy. […] The most common mechanism to explain diarrhea in chronic radiation enteritis is bile acid malabsorption. Excess bile salts in the colon stimulate water secretion, leading to increased motility and diarrhea. […] Cholestyramine irreversibly binds bile salts, thus acting as a surrogate ileum and preventing concomitant electrolyte and water secretion into the colon. […] a patient who received pelvic radiation for a testicular seminoma while in his thirties, developed symptoms of radiation enteritis in his fifties, and was successfully treated with cholestyramine at age 74.

• #1 Radiation enteritis

  https://sales-demo.adam.com/content.aspx?productid=140&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: […] There often are no good treatments for chronic radiation enteritis that is more severe. […] You may need to consider surgery to either remove or go around (bypass) a section of damaged intestine.

• #1 Radiation enteritis: MedlinePlus Medical EncyclopediaLock

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

  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. […] Some things can make symptoms worse, and should be avoided. These include: Alcohol and tobacco, Almost all milk products, Coffee, tea, chocolate, and sodas with caffeine, Foods containing whole bran, Fresh and dried fruits, Fried, greasy, or fatty foods, Nuts and seeds, Popcorn, potato chips, and pretzels, Raw vegetables, Rich pastries and baked goods, Some fruit juices, Strong spices. […] Foods and drinks that are better choices include: Apple or grape juice, Applesauce, peeled apples, and bananas, Eggs, buttermilk, and yogurt, Fish, poultry, and meat that has been broiled or roasted, Mild, cooked vegetables, such as asparagus tips, green or black beans, carrots, spinach, and squash, Potatoes that have been baked, boiled, or mashed, Processed cheeses, such as American cheese, Smooth peanut butter, White bread, macaroni, or noodles.

• #1 Research progress and treatment of radiation enteritis and gut microbiota

  https://www.e-roj.org/journal/view.php?doi=10.3857/roj.2023.00346

  Hyperbaric oxygen therapy (HBOT) is the treatment of diseases by breathing pure or high oxygen levels under high pressure (above normal pressure). […] Fecal microbiota transplantation (FMT) refers to the transplantation of feces from a healthy donor into the intestines of patients after isolation and culture in vitro to change the composition of their gut microbiota and further affect the digestive, metabolic and immune functions of patients. […] Serious complications such as intestinal obstruction, intestinal necrosis or intestinal perforation may occur when the condition of radioactive intestinal injury progresses to the advanced stage, which will seriously endanger the life and safety of patients. At this time, surgical treatment is the main treatment method.

• #1 Successful Treatment of Radiation-Induced Colitis and Enteritis with Hyperbaric Oxygen Therapy

  https://digitalcommons.unmc.edu/gmerj/vol4/iss1/10/

  Previously irradiated tissue is characterized by changes including decreased vascularity, impaired cellular proliferation, and local hypoxia consistent with fibroblastic atrophy which can persist long after radiation therapy. […] Hyperbaric oxygen therapy has been shown to be beneficial in the treatment of complications arising from these late effects of radiation on normal tissue through enhancing fibroblast proliferation, collagen maturation, stem cell recruitment, and angiogenesis. […] Hyperbaric oxygen therapy should be routinely considered in the treatment of radiation-induced enteritis or colitis.

• #1 Research progress and treatment of radiation enteritis and gut microbiota

  https://www.e-roj.org/journal/view.php?doi=10.3857/roj.2023.00346

  Radiation enteritis is a kind of intestinal radiation injury in patients with pelvic and retroperitoneal malignancies after radiotherapy, and its occurrence and development process are very complicated. […] Treatment methods such as probiotics, antibiotics, and fecal microbiota transplantation are ways to correct the microbiota and may be an effective way to prevent and treat radiation enteritis. […] Currently, the treatment of radiation enteritis mainly includes nutritional support, drug therapy, regulation of intestinal flora, mucosal protection, anti-oxidation, prevention, and treatment of complications. Surgical treatment is required when medical treatment is ineffective. […] In the treatment of radiation intestinal injury, the value of parenteral nutrition combined with enteral support therapy has been widely recognized.

• #1 Research progress and treatment of radiation enteritis and gut microbiota

  https://www.e-roj.org/journal/view.php?doi=10.3857/roj.2023.00346

  At present, with further research on gut microbiota, the use of probiotics and prebiotics to treat radiation enteritis has become a research hotspot. […] Studies have confirmed that probiotics can be used in radiation enteritis, and the use of probiotic preparations such as Lactobacillus acidophilus, Bifidobacterium bifidum and Lactobacillus casei during pelvic radiotherapy resulted in a decrease in the average number of bowel movements and the incidence of diarrhea. […] Damage to the intestinal mucosal barrier from abdominal or pelvic radiation therapy can lead to gut microbiota translocation, flora imbalance and bacterial over reproduction, thus causing intestinal infection and aggravating abdominal pain and distension in patients. […] Clinically, the anti-inflammatory drugs commonly used to treat radiation enteritis include aminosalicylic acids and steroids.

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

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

  Sulfasalazine, 500 mg orally (PO) twice daily – This has been shown to help reduce the incidence and severity of radiation-induced enteropathy in patients receiving external beam RT (EBRT) to the pelvis. […] Amifostine – This prodrug is converted to its intracellular metabolite, WR-1065, which acts as a radioprotectant; amifostine administered intravenously (IV) in a dose of 340 mg/m2 is proved to decrease the incidence of radiation proctitis in patients receiving standard-dose radiotherapy for rectal cancer. […] The following medical treatments aim to control the symptoms of radiation-induced enteritis and proctitis: […] 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.

• #1 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. […] If the doctor suspects you have bacterial overgrowth, they will give you oral antibiotics along with electrolyte replacements and vitamins. […] Your doctor may recommend medications to relieve diarrhea. In some cases, you may be prescribed pain medicines. […] In some cases, the surgeon may have to cut the malfunctioning part of the bowel to ensure further surgery is not needed later. However, most experts do not consider this a good treatment option, because it can increase complications. […] 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.

• #1 Family

  https://patents.google.com/patent/ES2538478T3/en

  Rifaximina para uso en el tratamiento de la enteritis provocada por radioterapia, o para uso en tratar profilcticamente la enteritis w subjeto que ha de recibir radioterapia, en donde la rifaximina se administra entre uno i siedem dni przed pierwszą radioterapią u pacjenta, w trakcie radioterapii i/lub między 1 dniem a 60 dniami po zaprzestaniu radioterapii. […] Rifaximina para uso en la protección frente a la enteritis inducida por radiación antes, durante y/o después de someterse a una terapia de radiación, en donde la rifaximina se administra entre uno y siete días antes de la primera radioterapia al sujeto, durante la radioterapia y/o entre 5 días y 60 días después del cese de la radioterapia. […] La presente invención proporciona un nuevo tratamiento para la enteritis, incluida la radiación inducida con o sin la influencia de cirugía.

• #1 Family

  https://patents.google.com/patent/ES2538478T3/en

  La administración de rifaximina a un paciente que experimenta enteritis inducida por radiación reduce los síntomas de la afección. […] El uso de rifaximina para tratar la enteritis inducida por radiación es especialmente beneficioso, porque la rifaximina no se absorbe y no provoca una perturbación de la flora normal (especialmente el intestino delgado), que predispone a los pacientes a un hipercrecimiento bacteriano de bacterias patógenas y el tratamiento con rifaximina puede tratar y prevenir este hipercrecimiento bacteriano. […] La rifaximina se puede administrar antes, durante y/o después de las terapias de tratamiento. […] La rifaximina se puede administrar, por ejemplo, dos veces al día, tres veces al día o cuatro veces al día. […] La rifaximina se puede administrar en dosis, por ejemplo de entre 100 mg BID a 550 mg TID.

• #1 Radiation enteropathy – Wikipedia

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

  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. […] Endoscopic therapies including argon plasma coagulation have been used for bleeding telangiectasia in radiation proctitis and at other intestinal sites, although there is a risk of perforation.

• #1 Quality evaluation of guidelines for the diagnosis and treatment of radiation enteritis | Radiation Oncology | Full Text

  https://ro-journal.biomedcentral.com/articles/10.1186/s13014-023-02204-9

  To systematically evaluate the guidelines for the diagnosis and treatment of radioactive enteritis, compare their differences and reasons and provide some reference for updating them. […] Six diagnostic and therapeutic guidelines for radiation enteritis were included in this study, one of which, the American Society for Gastrointestinal Endoscopy guidelines, had an overall score of over 60%, which is worthy of clinical recommendation. In the diagnosis and treatment of radioactive rectal injury, the recommendations for hemorrhagic endoscopic treatment are mature and mainly include (I) argon plasma coagulation; (II) formalin treatment; (III) bipolar electrocoagulation; (IV) heater probe; (V) radiofrequency ablation; and (VI) cryoablation. […] The methodological quality of radioactive enteritis guidelines is unequal; even in the same guidelines, different domains have a large difference. For radioactive rectal damage diagnosis, a type of endoscopic treatment recommendation is more mature, but the overall diagnosis and treatment of radioactive enteritis still lacks high-quality research evidence.

• #1 Clinical Features and Management of Acute and Chronic Radiation-Induced Colitis and Proctopathy

  https://www.mdpi.com/2072-6694/15/12/3160

  Radiation-induced colitis and proctopathy (RICAP) is a recognized adverse effect of radiation therapy (RT) that can adversely affect cancer patients’ quality of life. […] The treatment of RICAP relies on medical management with antidiarrheal agents, corticosteroid suppositories or enemas, and fluid resuscitation. […] Interventional endoscopic techniques, which have advanced substantially in recent years, can be used in select cases. Argon plasma coagulation (APC), which has replaced traditionally used bipolar devices, is the most-used endoscopic intervention for RICAP-associated bleeding, given its limited depth of coagulation (0.5–3 mm). […] Medical management should be considered before endoscopic therapy. APC may be useful in patients with endoscopically apparent bleeding. […] However, APC treatment did not significantly reduce bleeding recurrence or RICAP symptoms.

• #1 Quality evaluation of guidelines for the diagnosis and treatment of radiation enteritis | Radiation Oncology | Full Text

  https://ro-journal.biomedcentral.com/articles/10.1186/s13014-023-02204-9

  Four guidelines supported the use of argon plasma coagulation, and two guidelines did not mention it. […] Four guidelines mentioned or supported topical application of formalin, and two guidelines did not. […] Three guidelines mentioned or supported bipolar electrocoagulation, and three did not. […] Two of the included guidelines referred to heater probes, and the remaining four did not. […] Only one guideline referred to radiofrequency ablation, and there were three case reports involving 66 patients, with an overall success rate of 97.0% and bleeding improvement. […] Cryoablation was mentioned in only one guideline, which referred to two case reports involving 10 and 7 patients with 70% and 100% response rates, respectively, and an adverse reaction (perforation) rate of 10%. […] This study provides some suggestions for the future diagnosis and treatment of radioactive enteritis: (I) Guideline authors should use systematic retrieval methods for evidence retrieval when writing guidelines, and display the diagnosis and treatment methods of radioactive enteritis as comprehensively as possible. […] It is hoped that these observations will be taken into account when new guidelines are developed.

• #1 Radiation Enteritis and Proctitis: Practice Essentials, Pathophysiology, Etiology

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

  Radiation therapy (RT) is a mainstay in the treatment of both primary and recurrent gastrointestinal (GI) and pelvic malignancies. Combining treatment modalities (surgery, chemotherapy, RT) allows for the best possible outcome in patients with these malignancies. One of the major and debilitating adverse effects of RT is the development of radiation enteritis and proctitis. Both radiation enteritis and radiation proctitis have acute (early) and chronic (late) manifestations. […] Treatment of these patients is extremely challenging. Initial nonoperative modalities include diet modification, nutritional support, and control of symptoms with medications. Severe, progressive disease may require surgical intervention, especially for complications, such as fistula formation, obstruction, perforation, and hemorrhage.

• #1 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 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. […] Preventive measures include medical therapies to decrease the effects of radiation on the gastrointestinal (GI) tract. The commonly used methods of prevention include the following:

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

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

  Surgical procedures for prevention of radiation enteritis are based on the principles of reperitonealization and abdominopelvic partitioning. […] 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. […] 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. […] Most often, hemorrhagic proctitis is adequately treated with endoscopic APC or Nd:YAG laser treatment, heater probe coagulation, or application of formalin. […] Rectovaginal fistulas and rectal strictures are a common problem with irradiation. The treatment approach is transabdominal for high fistulas and perineal for low fistulas.

• #1 Radiation Enteritis – StatPearls – NCBI Bookshelf

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

  As a consequence of chronic radiation, Patients who have enteritis leading to the formation of intestinal strictures, fistulas, and perforations require surgical procedures. […] 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.

• #1 Radiation Enteritis and Proctitis: Practice Essentials, Pathophysiology, Etiology

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

  The history of surgical prevention of small-bowel radiation injury is based on the principle of abdominopelvic partitioning. The goal of this procedure is to keep the highly radiation-sensitive small intestine out of the pelvis. […] Historically, the surgical procedures to treat the complications of radiation enteritis have been as minimally invasive as possible, with the goal of relieving symptoms. Patients with fistulas and obstruction underwent bypass, and patients with bleeding associated with radiation proctitis underwent diverting colostomy. […] Surgical procedures on radiated intestine carry a morbidity of 12-65% and a mortality of 2-13%. The wide range reflects the diverse surgical procedures used to treat complications of radiation. […] Almost 50% of patients who survive a laparotomy for radiation-induced bowel injury require further surgery for ongoing bowel damage from radiation. A mortality as high as 25% is reported for patients who require a second surgical procedure. The mortality is directly attributable to the radiation enteritis and complications of treatment.

• #1 radiation enteritis

  https://www.aboutcancer.com/radiation_enteritis_utd_807.htm

  Antidiarrheal agents Judicious use of antidiarrheal agents (such as loperamide) can help improve diarrhea, although it should not be used in patients with suspected small or large bowel obstruction. […] Antibiotics may reduce symptoms in patients in whom bacterial overgrowth has developed. […] A mainstay of the medical therapy of severe chronic radiation enteritis has been total parenteral nutrition (TPN), the success of which is similar for other intestinal disorders requiring TPN. […] As noted above, surgery for radiation enteritis should be avoided if possible because of several inherent difficulties in operating on patients with chronic radiation injury. […] Despite attempts at conservative management, approximately one-third of patients progress to the point where surgery is required.

• #1 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.

• #1 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 will work with you to review all your treatment options and choose the treatment that best suits your needs and goals. […] 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. […] Each year, nearly 100 people with radiation enteritis receive care at Mayo Clinic.

• #1

  https://link.springer.com/article/10.1007/s11938-999-0027-0

  Ideally, treatment of radiation enteritis begins with preventive measures taken before the first fraction of radiotherapy is delivered. Careful planning by the radiation oncologist is done to avoid excessive exposure to the small bowel. Fractionated therapy should be performed to avoid the delivery of large single fractions while still administering an effective dose of radiation. […] The prophylactic use of antioxidant and radioprotectant agents such as vitamin E or amifostine may be considered on protocol (preferably as a double blind controlled trial to improve our knowledge of its efficacy), if locally available, to limit damage secondary to lipid membrane peroxidation and oxygen free radical generation. […] Dietary modification to a low-fat, low-residue, lactose-free diet is often helpful and should be well tolerated. When faced with severe chronic diarrhea secondary to intestinal failure, a glutamine-enriched elemental diet or total parenteral nutrition would be ideal. Unfortunately, these measures are expensive, somewhat impractical, and not often possible to administer, especially in the setting of an outpatient radiation regimen.

• #1 Radiation Enteritis and Proctocolitis – Clinical Tree

  https://clinicalpub.com/radiation-enteritis-and-proctocolitis/

  Radiation enteritis is categorized as acute and chronic. Acute injury occurs during radiotherapy and may last up to 6 months, whereas chronic injury occurs after 3 months and may even present 50 years after radiation was administered. […] Patients who experience extreme symptoms of acute radiation injury have a higher risk of the development of chronic radiation enteritis, which is called consequential late effect. […] Careful planning can minimize exposure to radiation. Physical maneuvers have been attempted, such as prone positioning, use of a belly board, and distension of the bladder to displace the small bowel out of the pelvis. In addition, tissue expanders, biodegradable mesh slings, and intrapelvic breast prostheses have been shown to minimize pelvic radiation exposure by up to 50%. CT scanning simulation techniques, intensity-modulated radiation therapy, and brachytherapy targeting radiation to the cancer decrease extraneous exposure compared with nonspecific external beam radiation.

• #2 Radiation Enteritis: Treatment & Management

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

  Radiation enteritis is a condition that occurs when radiation therapy causes damage to your intestines. Radiation therapy uses radioactive substances to destroy abnormal cells. Its a common treatment for cancer and certain blood disorders. […] Treatment typically requires regular exposure to radioactive substances for several weeks. When radiation reaches healthy cells, it causes inflammation and tissue damage. Cells in the lining of your intestines are more sensitive to the effects of radiation. […] 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, medications that slow intestinal activity to relieve diarrhea. Corticosteroids to quiet inflammation in your intestines. Pain relievers.

• #2 Radiation enteritis: MedlinePlus Medical EncyclopediaLock

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

  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). […] 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. Medicines such as cholestyramine, diphenoxylate-atropine, loperamide, or sucralfate may help. Thermal therapy (argon laser probe, plasma coagulation, heater probe). You may need to consider surgery to either remove or go around (bypass) a section of damaged intestine.

• #2 Radiation enteritis | Canadian Cancer Society

  https://cancer.ca/en/treatments/side-effects/radiation-enteritis

  Radiation enteritis is damage to the lining of the small and large intestines caused by radiation therapy to the abdomen, rectum or pelvis. […] Your healthcare team may recommend medicines to treat radiation enteritis, such as: […] drugs to relieve diarrhea […] pain medicines […] corticosteroids to relieve inflammation of the rectum.

• #2 Role of triamcinolone in radiation enteritis management

  https://www.wjgnet.com/1007-9327/full/v20/i15/4341.htm

  AIM: To investigate the role of triamcinolone in the management of acute and chronic enteritis caused by pelvic radiotherapy. […] Triamcinolone was found to effectively prevent and treat radiation-induced acute gastrointestinal (enteritis) and genitourinary (cystitis) side effects (P= 0.022 and P = 0.023). […] CONCLUSION: Triamcinolone is a moderately potent steroid, that is inexpensive and has a good safety profile. It would be beneficial for reducing medical expenses related to treatment of radiation induced enteritis. […] An important effort should be made to treat the side effects and to provide patient follow-up. Many drugs are available to treat the side effects, and although supportive digestive supplements may be used, the medical expenses associated with treatment are increasing, and the patients are suffering.

• #2 Neural block therapy for radiation enteritis: a case report | JA Clinical Reports | Full Text

  https://jaclinicalreports.springeropen.com/articles/10.1186/s40981-019-0239-9

  Radiation enteritis following radiotherapy targeting the abdomen occasionally causes ulcers or ileus, which can be difficult to treat and usually progressive and refractory, significantly degrading the patients quality of life. […] However, visceral sympathetic nerve block may show efficacy as a potential therapy for radiation enteritis-associated abdominal pain and ileus. […] Splanchnic nerve block and inferior mesenteric arterial plexus block procedures improved both the abdominal pain and the ileus symptoms. […] The results of the present case suggest that a sympathetic nerve block procedure in the abdomen, such as a splanchnic nerve block or inferior mesenteric plexus block, may improve symptoms associated with radiation enteritis. […] Sympathetic nerve blocks for abdominal organs may offer one of the few treatments for radiation enteritis.

• #2 Radiation Enteritis | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/117441/all/Radiation_Enteritis?q=Acute+Pancreatitis%2C

  Radiation enteritis (RE) is an inflammatory injury to the large and small intestines resulting from radiation therapy (RT). […] Therapeutic options for chronic RE are limited. […] Surgical resection has a role in selected cases. […] 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.

• #2 Radiation enteritis

  https://sales-demo.adam.com/content.aspx?productid=140&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: […] There often are no good treatments for chronic radiation enteritis that is more severe. […] You may need to consider surgery to either remove or go around (bypass) a section of damaged intestine.

• #2 Radiation enteritis: MedlinePlus Medical EncyclopediaLock

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

  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. […] Some things can make symptoms worse, and should be avoided. These include: Alcohol and tobacco, Almost all milk products, Coffee, tea, chocolate, and sodas with caffeine, Foods containing whole bran, Fresh and dried fruits, Fried, greasy, or fatty foods, Nuts and seeds, Popcorn, potato chips, and pretzels, Raw vegetables, Rich pastries and baked goods, Some fruit juices, Strong spices. […] Foods and drinks that are better choices include: Apple or grape juice, Applesauce, peeled apples, and bananas, Eggs, buttermilk, and yogurt, Fish, poultry, and meat that has been broiled or roasted, Mild, cooked vegetables, such as asparagus tips, green or black beans, carrots, spinach, and squash, Potatoes that have been baked, boiled, or mashed, Processed cheeses, such as American cheese, Smooth peanut butter, White bread, macaroni, or noodles.

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

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

  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 drink alcohol. […] Avoid tobacco use. […] Do not eat spicy foods. […] Avoid eating fatty or fried foods until the symptoms of radiation enteritis go away.

• #2 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. […] Radiation enteritis often is temporary. Your symptoms may subside in the weeks after your treatment ends. During this time, treatments may help relieve your symptoms. If radiation enteritis persists, other treatments may be recommended. […] 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.

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

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

  Sulfasalazine, 500 mg orally (PO) twice daily – This has been shown to help reduce the incidence and severity of radiation-induced enteropathy in patients receiving external beam RT (EBRT) to the pelvis. […] Amifostine – This prodrug is converted to its intracellular metabolite, WR-1065, which acts as a radioprotectant; amifostine administered intravenously (IV) in a dose of 340 mg/m2 is proved to decrease the incidence of radiation proctitis in patients receiving standard-dose radiotherapy for rectal cancer. […] The following medical treatments aim to control the symptoms of radiation-induced enteritis and proctitis: […] 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.

• #2 Radiation enteropathy – Wikipedia

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

  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. […] Endoscopic therapies including argon plasma coagulation have been used for bleeding telangiectasia in radiation proctitis and at other intestinal sites, although there is a risk of perforation.

• #2 Research progress and treatment of radiation enteritis and gut microbiota

  https://www.e-roj.org/journal/view.php?doi=10.3857/roj.2023.00346

  At present, with further research on gut microbiota, the use of probiotics and prebiotics to treat radiation enteritis has become a research hotspot. […] Studies have confirmed that probiotics can be used in radiation enteritis, and the use of probiotic preparations such as Lactobacillus acidophilus, Bifidobacterium bifidum and Lactobacillus casei during pelvic radiotherapy resulted in a decrease in the average number of bowel movements and the incidence of diarrhea. […] Damage to the intestinal mucosal barrier from abdominal or pelvic radiation therapy can lead to gut microbiota translocation, flora imbalance and bacterial over reproduction, thus causing intestinal infection and aggravating abdominal pain and distension in patients. […] Clinically, the anti-inflammatory drugs commonly used to treat radiation enteritis include aminosalicylic acids and steroids.

• #2 Research progress and treatment of radiation enteritis and gut microbiota

  https://www.e-roj.org/journal/view.php?doi=10.3857/roj.2023.00346

  Hyperbaric oxygen therapy (HBOT) is the treatment of diseases by breathing pure or high oxygen levels under high pressure (above normal pressure). […] Fecal microbiota transplantation (FMT) refers to the transplantation of feces from a healthy donor into the intestines of patients after isolation and culture in vitro to change the composition of their gut microbiota and further affect the digestive, metabolic and immune functions of patients. […] Serious complications such as intestinal obstruction, intestinal necrosis or intestinal perforation may occur when the condition of radioactive intestinal injury progresses to the advanced stage, which will seriously endanger the life and safety of patients. At this time, surgical treatment is the main treatment method.

• #2 Treatment of chronic radiation enteritis and colitis with salicylazosulfapyridine and systemic corticosteroids (Conference) | OSTI.GOV

  https://www.osti.gov/biblio/7323840

  Four patients with severe chronic radiation enteritis and/or colitis were treated with anti-inflammatory drugs that are used conventionally in the treatment of idiopathic inflammatory bowel disease. Salicylazosulfapyridine (SASP) was used in the treatment of all four patients, while one patient received oral prednisone together with SASP. All four patients were treated and observed for over one year, with follow-up observations now extending to over three years. The four patients showed striking clinical improvement, accompanied by improvement in the radiographic appearance of affected bowel, complete or almost complete in three and incomplete in the fourth patient. The results of this pilot investigation are encouraging and call for wider clinical trials of the same and related drugs in larger groups of patients with chronic radiation enterocolitis, a serious condition that has until now not been successfully treated with drugs.

• #2 Family

  https://patents.google.com/patent/ES2538478T3/en

  La administración de rifaximina a un paciente que experimenta enteritis inducida por radiación reduce los síntomas de la afección. […] El uso de rifaximina para tratar la enteritis inducida por radiación es especialmente beneficioso, porque la rifaximina no se absorbe y no provoca una perturbación de la flora normal (especialmente el intestino delgado), que predispone a los pacientes a un hipercrecimiento bacteriano de bacterias patógenas y el tratamiento con rifaximina puede tratar y prevenir este hipercrecimiento bacteriano. […] La rifaximina se puede administrar antes, durante y/o después de las terapias de tratamiento. […] La rifaximina se puede administrar, por ejemplo, dos veces al día, tres veces al día o cuatro veces al día. […] La rifaximina se puede administrar en dosis, por ejemplo de entre 100 mg BID a 550 mg TID.

• #2 Family

  https://patents.google.com/patent/ES2538478T3/en

  La rifaximina se puede administrar, por ejemplo, en forma de comprimido, en forma de polvo, líquido o en cápsulas. […] La administración de rifaximina puede ser de al menos un día antes de la primera dosis de radioterapia al sujeto. […] La rifaximina se puede administrar durante la terapia de radiación. […] La rifaximina se puede administrar a un sujeto de entre 2 semanas a 6 semanas de duración, de entre 8 semanas a 12 semanas de duración, o de entre 1 día a 7 días. […] La rifaximina se puede administrar de forma intermitente o continua durante el curso del tratamiento. […] La cantidad de rifaximina administrada diariamente puede aumentarse o disminuirse en función del peso, edad, salud, sexo o condición médica del sujeto. […] La toxicidad y la eficacia de los protocolos profilácticos y/o terapéuticos de la presente invención pueden determinarse mediante procesos farmacéuticos estándares en cultivos celulares o animales experimentales.

• #2 Quality evaluation of guidelines for the diagnosis and treatment of radiation enteritis | Radiation Oncology | Full Text

  https://ro-journal.biomedcentral.com/articles/10.1186/s13014-023-02204-9

  The guidelines focused on the treatment of radiation enteritis, such as the later management of cancer treatment, intestinal management of radiation enteritis, and endoscopic treatment of hemorrhagic radiation enteritis. […] The treatment methods mentioned in different radiation enteritis guidelines vary widely. […] The recommendations included in the guidelines varied widely; therefore, we further analyzed the consistency and controversy between current recommendations and the corresponding evidence for the management of radioactive enteritis. […] The fact that most of the supporting evidence mentions safety uncertainty is also troubling. This reflects the lack of scientific investment in this disease and the need for more high-quality RCTs, which is a major obstacle to the development of high-quality guidelines.

• #2 Quality evaluation of guidelines for the diagnosis and treatment of radiation enteritis | Radiation Oncology | Full Text

  https://ro-journal.biomedcentral.com/articles/10.1186/s13014-023-02204-9

  Four guidelines supported the use of argon plasma coagulation, and two guidelines did not mention it. […] Four guidelines mentioned or supported topical application of formalin, and two guidelines did not. […] Three guidelines mentioned or supported bipolar electrocoagulation, and three did not. […] Two of the included guidelines referred to heater probes, and the remaining four did not. […] Only one guideline referred to radiofrequency ablation, and there were three case reports involving 66 patients, with an overall success rate of 97.0% and bleeding improvement. […] Cryoablation was mentioned in only one guideline, which referred to two case reports involving 10 and 7 patients with 70% and 100% response rates, respectively, and an adverse reaction (perforation) rate of 10%. […] This study provides some suggestions for the future diagnosis and treatment of radioactive enteritis: (I) Guideline authors should use systematic retrieval methods for evidence retrieval when writing guidelines, and display the diagnosis and treatment methods of radioactive enteritis as comprehensively as possible. […] It is hoped that these observations will be taken into account when new guidelines are developed.

• #2 Treatment of Chronic Radiation Proctitis (2018) | ASCRS Toolkit – FREE Resources

  https://www.ascrsu.com/ascrs/view/ASCRS-Toolkit/2851049/all/Treatment_of_Chronic_Radiation_Proctitis

  Short chain fatty acid enemas are not effective in preventing or treating chronic hemorrhagic radiation proctitis and are not recommended. […] Many alternative treatments, such as mesalamine, ozone therapy, and metronidazole, have been described in the treatment of radiation proctitis. These treatments have not been thoroughly evaluated and are not recommended in the treatment of CRP. […] Endoscopic argon beam plasma coagulation is a safe and effective treatment for rectal bleeding induced by CRP. […] A median of 2 APC sessions is typically required to control rectal hemorrhage. […] Hyperbaric oxygen therapy is an effective treatment modality to reduce bleeding in patients with CRP. […] Although there is a clear benefit to HBOT in patients with CRP, it is an expensive therapy that requires specialized equipment and several weeks of treatment sessions; thus, it is not widely available. […] Endoscopic bipolar electrocoagulation, radiofrequency ablation, Nd-YAG laser, and cryotherapy are alternative treatments of rectal bleeding from CRP that have been insufficiently evaluated and are thus not recommended.

• #2 Treatment of Chronic Radiation Proctitis (2018) | ASCRS Toolkit – FREE Resources

  https://www.ascrsu.com/ascrs/view/ASCRS-Toolkit/2851049/all/Treatment_of_Chronic_Radiation_Proctitis

  Formalin application is an effective treatment for bleeding in patients with CRP. […] The treatment can be rendered in the outpatient clinic setting with the patient awake or in a minor procedure room under intravenous sedation. […] An additional study from Poland reported the outcome of 4% formalin application in 20 patients with radiation proctitis. Most patients required an average of 2 treatments. After the first application, 50% of the patients had complete resolution of the symptoms. […] Sucralfate retention enemas are a moderately effective treatment for rectal bleeding resulting from CRP. […] A subsequent study of 26 patients, all of whom were treated with a 10% sucralfate suspension in water administered twice daily, resulted in a significant decrease in rectal bleeding after 4 weeks of therapy, including negligible or complete cessation of bleeding in 23 patients (88%) after 16 weeks of therapy and no recurrent bleeding in 71% patients who were followed for a median of 45 months.

• #2 Radiation Enteritis: Treatment & Management

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

  The options that are right for you depend on the type of complication. Strictures, fistulas and perforations often need surgery. You may need supplements or tube feeding if you arent getting enough nutrients. […] If youre experiencing symptoms of radiation enteritis, talk to your healthcare provider. Treatments can relieve discomfort and lower the risk of complications.

• #2 Radiation Enteritis – StatPearls – NCBI Bookshelf

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

  As a consequence of chronic radiation, Patients who have enteritis leading to the formation of intestinal strictures, fistulas, and perforations require surgical procedures. […] 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.

• #2 Radiation enteropathy – Wikipedia

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

  Surgical treatment may be needed for intestinal obstruction, fistulae, or perforation, which can happen in more severe cases. These can be fatal if patients present as an emergency, but with improved radiotherapy techniques are now less common. A systematic review has found there is some promising evidence for non-surgical interventions for late rectal damage, however due to low quality evidence no conclusions could be drawn. Optimal treatment usually produces significant improvements in quality of life.

• #2 Radiation Enteritis – MD Searchlight

  https://mdsearchlight.com/gut-health/radiation-enteritis/

  Serious complications like strictures, fistulas, and perforations may require surgical intervention, but it is important to remove all irradiated sections of the bowel in the initial operation to potentially limit the need for further surgeries. Removing scar tissue or creating bypass routes may not be as helpful as removing the entire diseased portion of the bowel. […] Surgery for treating radiation enteritis is considered high risk. About 30% of patients often end up needing additional surgical procedures afterward. Some common issues that can occur after the surgery include: Anastomotic leakage: This is when a connection made during surgery between two parts of the intestines starts to leak. […] It is important for doctors to actively monitor for any signs of the cancer coming back and to manage symptoms such as diarrhea and malabsorption.

• #2 Radiation Enteritis – MD Searchlight

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

  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. However, one study found that patients frequently faced health challenges after their first surgery, with many requiring nutrition delivered directly into their bloodstream (parenteral nutrition). […] Its deemed beneficial to remove all irradiated sections of the bowel in the initial operation to potentially limit the need for further surgeries. But this isnt always an option, as removing too much intestinal tract can result in a complication called short bowel syndrome, where the body cant absorb enough nutrients from food. […] Surgery for treating radiation enteritis is considered high risk. About 30% of patients often end up needing additional surgical procedures afterward.

• #2

  https://link.springer.com/article/10.1007/s11938-999-0027-0

  Ideally, treatment of radiation enteritis begins with preventive measures taken before the first fraction of radiotherapy is delivered. Careful planning by the radiation oncologist is done to avoid excessive exposure to the small bowel. Fractionated therapy should be performed to avoid the delivery of large single fractions while still administering an effective dose of radiation. […] The prophylactic use of antioxidant and radioprotectant agents such as vitamin E or amifostine may be considered on protocol (preferably as a double blind controlled trial to improve our knowledge of its efficacy), if locally available, to limit damage secondary to lipid membrane peroxidation and oxygen free radical generation. […] Dietary modification to a low-fat, low-residue, lactose-free diet is often helpful and should be well tolerated. When faced with severe chronic diarrhea secondary to intestinal failure, a glutamine-enriched elemental diet or total parenteral nutrition would be ideal. Unfortunately, these measures are expensive, somewhat impractical, and not often possible to administer, especially in the setting of an outpatient radiation regimen.

• #2 Chronic Radiation Enteritis — Cancer Survivors Network

  https://csn.cancer.org/discussion/250817/chronic-radiation-enteritis

  Use a good multivitamin and make sure it contains vitamin D, as most CRE patients are vit D depleted. […] I have agreed to try a medication called Trental (Pentoxifylline) that has been said to help soften the scar tissue in the intestines. […] I am also going to start some of the diet suggestions I have read on here, there are so many good tips.

• #2 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 will work with you to review all your treatment options and choose the treatment that best suits your needs and goals. […] 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. […] Each year, nearly 100 people with radiation enteritis receive care at Mayo Clinic.

• #2 Radiation Enteritis in Patients Receiving Abdominal Radiation Therapy | SpringerLink

  https://link.springer.com/chapter/10.1007/978-981-99-0984-1_3

  Radiation enteritis (RE) is a known toxicity arising from radiation therapy to abdomen and pelvis. Effective management of RE requires its identification, investigations, dietary as well as medical intervention. […] Severe cases needs multidisciplinary approach and may require more intensive medical management. […] The efficacy of octreotide in the therapy of acute radiation-induced diarrhea: a randomized controlled study. […] Role of triamcinolone in radiation enteritis management. […] Hyperbaric oxygen therapy for late radiation tissue injury. […] Surgical management of radiation enteritis.

• #2 Radiation Enteritis and Proctocolitis | Abdominal Key

  https://abdominalkey.com/radiation-enteritis-and-proctocolitis/

  Radiation therapy is a common treatment for gynecologic, urologic, and rectal malignancies. […] Radiation enteritis is categorized as acute and chronic. Acute injury occurs during radiotherapy and may last up to 6 months, whereas chronic injury occurs after 3 months and may even present 50 years after radiation was administered. […] Patients who experience extreme symptoms of acute radiation injury have a higher risk of the development of chronic radiation enteritis, which is called consequential late effect. […] Careful planning can minimize exposure to radiation. Physical maneuvers have been attempted, such as prone positioning, use of a belly board, and distension of the bladder to displace the small bowel out of the pelvis.

• #2 Family

  https://patents.google.com/patent/ES2538478T3/en

  Rifaximina para uso en el tratamiento de la enteritis provocada por radioterapia, o para uso en tratar profilcticamente la enteritis w subjeto que ha de recibir radioterapia, en donde la rifaximina se administra entre uno i siedem dni przed pierwszą radioterapią u pacjenta, w trakcie radioterapii i/lub między 1 dniem a 60 dniami po zaprzestaniu radioterapii. […] Rifaximina para uso en la protección frente a la enteritis inducida por radiación antes, durante y/o después de someterse a una terapia de radiación, en donde la rifaximina se administra entre uno y siete días antes de la primera radioterapia al sujeto, durante la radioterapia y/o entre 5 días y 60 días después del cese de la radioterapia. […] La presente invención proporciona un nuevo tratamiento para la enteritis, incluida la radiación inducida con o sin la influencia de cirugía.

• #3 Radiation enteritis: MedlinePlus Medical EncyclopediaLock

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

  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). […] 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. Medicines such as cholestyramine, diphenoxylate-atropine, loperamide, or sucralfate may help. Thermal therapy (argon laser probe, plasma coagulation, heater probe). You may need to consider surgery to either remove or go around (bypass) a section of damaged intestine.

• #3

  https://link.springer.com/article/10.1007/s11938-999-0027-0

  Agents such as sulfasalazine, mesalamine, sucralfate, and cholestyramine have been used with variable results. These agents may be offered adjunctively on a case-by-case basis. […] Opiates, such as loperamide, and anticholinergics are widely used to control the symptoms of diarrhea and abdominal cramping.

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

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

  Oral sulfasalazine (Azulfidine) for prevention; sucralfate enema for chronic proctitis; hyperbaric oxygen for refractory radiation proctitis. […] Acute enteritis secondary to radiation therapy is usually a self-limiting process treated conservatively with dietary changes and antidiarrheal medications. […] Chronic symptoms begin three months or more after completion of radiation therapy and may last indefinitely. […] Mild intermittent symptoms of chronic enteritis are managed with a low-residue diet, stool softeners, and loperamide (Imodium). […] Hyperbaric oxygen therapy significantly improved healing responses in patients with refractory radiation proctitis in a study of 120 patients. […] Intravenous hydration and uroprotective agents, including mesna (Mesnex) and amifostine, have demonstrated effectiveness in treating hemorrhagic cystitis. […] The addition of dexamethasone (4 mg daily for five days) to the receptor antagonist 5-HT3 ondansetron (Zofran) provides additional benefit for prophylaxis against radiation-induced emesis.

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

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

  Diarrhea is a common problem in patients receiving pelvic irradiation with concurrent chemotherapy. […] The incidence and severity of diarrhea vary with the chemotherapy type and dose, radiotherapy field size, daily fraction size, and total dose of radiation given. […] It is obvious that by reducing the chemoradiation-induced bowel symptoms, the patients quality of life during (and following) therapy can be enhanced. […] Additionally, minimizing the severity of radiation-induced enteritis may increase the probability of completing the planned treatment without interruption and improve the outcome. […] Octreotide (Sandostatin), a somatostatin analog, is very effective in controlling grade 3 diarrhea associated with chemotherapy. […] Octreotide seems to control diarrhea by decreasing intestinal motility and increasing absorption of water and electrolytes.

• #3 Treatment of Chronic Radiation Proctitis (2018) | ASCRS Toolkit – FREE Resources

  https://www.ascrsu.com/ascrs/view/ASCRS-Toolkit/2851049/all/Treatment_of_Chronic_Radiation_Proctitis

  Short chain fatty acid enemas are not effective in preventing or treating chronic hemorrhagic radiation proctitis and are not recommended. […] Many alternative treatments, such as mesalamine, ozone therapy, and metronidazole, have been described in the treatment of radiation proctitis. These treatments have not been thoroughly evaluated and are not recommended in the treatment of CRP. […] Endoscopic argon beam plasma coagulation is a safe and effective treatment for rectal bleeding induced by CRP. […] A median of 2 APC sessions is typically required to control rectal hemorrhage. […] Hyperbaric oxygen therapy is an effective treatment modality to reduce bleeding in patients with CRP. […] Although there is a clear benefit to HBOT in patients with CRP, it is an expensive therapy that requires specialized equipment and several weeks of treatment sessions; thus, it is not widely available. […] Endoscopic bipolar electrocoagulation, radiofrequency ablation, Nd-YAG laser, and cryotherapy are alternative treatments of rectal bleeding from CRP that have been insufficiently evaluated and are thus not recommended.

• #3 Treatment of Chronic Radiation Proctitis (2018) | ASCRS Toolkit – FREE Resources

  https://www.ascrsu.com/ascrs/view/ASCRS-Toolkit/2851049/all/Treatment_of_Chronic_Radiation_Proctitis

  Prophylactic measures, such as pedicled omental flap and tissue expander implant, have been described to decrease the incidence of radiation proctitis. These techniques are insufficiently evaluated and are not routinely recommended. […] Although this approach may reduce small-bowel enteritis, radiation proctitis was still seen in as many as 33% of patients. Other strategies, such as tissue expander implant, have been described, but there is not sufficient evidence to support its use. […] Other adjuncts, such as oral glutamine during radiation, have been described. Although 1 study suggested decreased proctitis symptom severity in patients treated with glutamine, another relatively recent randomized controlled trial suggested that the incidence of radiation proctitis in a modern series is low and that no benefit was derived from prophylactic glutamine administration. Short chain fatty acid enemas given during radiation therapy were also studied in a randomized controlled trial and showed no benefit in preventing radiation proctitis.

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

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

  Octreotide has also been shown to be effective in controlling severe radiation-induced diarrhea not responding to loperamide. […] The role of octreotide in the prevention of grade 3 diarrhea has not been studied in patients receiving radiation therapy. […] The primary objective of the study is to show a 50% reduction in the incidence of grade 3 diarrhea using octreotide LAR depot. […] 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.

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