Materiały źródłowe

• #1 Pharmacological interventions for the prevention and treatment of radiation colitis, enteritis and proctitis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6464563/

  The aim of the study is to assess the efficacy of different pharmacological therapies for the treatment and prevention of radiation colitis, enteritis and proctitis in patients who are past recipients of radiation therapy. […] Most advancements made in the prevention of radiation injury are nonpharmacologic and include reducing the dosage of radiation (also known as intensity modulated radiotherapy) reducing the area of intestinal exposure to radiotherapy, multiple field arrangement and conformal radiotherapy techniques (three dimensional radiotherapy). These techniques have been relatively successful with a 25-40% reduction in both acute and chronic gastrointestinal toxicity. […] Amongst the pharmacologic therapies, aminosalicylic acid derivatives, sucralfate preparations and nutritional therapies are the most studied.

• #2 Radiation Enteropathy – Pathogenesis, Treatment, and Prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4346191/

  There has been only modest change in cancer incidence and mortality during the past several decades, but the number of cancer survivors has almost tripled during the same period. […] Many cancer survivors have undergone radiation therapy of tumors in the pelvis or abdomen, thus rendering the bowel at risk for injury. […] Significant progress toward reducing toxicity of radiation therapy has been made by the introduction of so-called dose-sculpting treatment techniques, which allow more precise delivery of the radiation beam. […] This review article discusses radiation enteropathy as a clinical problem, pathological features of radiation enteropathy, cellular and molecular mechanisms of radiation enteropathy, and contemporary approaches for prevention and management of radiation enteropathy.

• #3 Radiation enteropathy – Wikipedia

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

  Prevention of radiation injury to the small bowel is a key aim of techniques such as brachytherapy, field size, multiple field arrangements, conformal radiotherapy techniques and intensity-modulated radiotherapy. Medications including ACE inhibitors, statins and probiotics have also been studied and reviewed.

• #4 Radiation Enteritis: Treatment & Management

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

  What can be done to prevent radiation enteritis? […] There are steps your care team can take to protect your intestines during radiation therapy. These include: […] Custom positioning devices to hold your body still during treatments. […] Modern treatments, like intensity-modulated radiation therapy (IMRT) that deliver radiation to precisely the right spot. […] Protective shields for your bowel or rectum. […] If youre undergoing radiation therapy, there are steps healthcare providers can take to shield healthy tissue from radiation exposure.

• #5 Radiation Enteritis: Causes, Symptoms, Types, Risk Factors

  https://www.prepladder.com/neet-pg-study-material/radiology/radiation-enteritis-causes-symptoms-types-risk-factors-diagnosis-treatment-prevention-and-complications

  […] […] While you get radiation therapy, your medical team can take certain safety measures to protect your intestines. They include: […] Personalized positioning tools to maintain your body still during treatment. […] Radiation therapy that precisely targets a specific location is called intensity-modulated radiation therapy, or IMRT. […] Barriers that cover your colon or lower rectum. […] […]

• #6 Radiation Enteritis | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/117441/1.0/Radiation_Enteritis

  General Prevention […] Physical measures […] Belly board device to reduce volume delivered to organs during abdominal and pelvic radiation […] Surgical placement of intestinal sling […] Bladder distension during RT […] Trendelenburg position in pelvic RT […] Treatment measures […] Reduce field size. […] Multiple field arrangements […] Intensity-modulated RT […] Brachytherapy […] 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 (1,5).

• #7 Radiation Enteritis | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/117441/1.0/Radiation_Enteritis

  General Prevention […] Physical measures […] Belly board device to reduce volume delivered to organs during abdominal and pelvic radiation […] Surgical placement of intestinal sling […] Bladder distension during RT […] Trendelenburg position in pelvic RT […] Treatment measures […] Reduce field size. […] Multiple field arrangements […] Intensity-modulated RT […] Brachytherapy […] 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 (1,5).

• #8 Proctitis

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

  The primary approach to the prevention of radiation proctitis is to minimise the radiation dose to the rectum through highly conformal treatment using image-guided radiation therapy (IGRT) and intensity-modulated radiation therapy (IMRT) and/or volumetric arc therapy (VMAT). Other physical techniques have been used to minimise the dose of radiation reaching normal tissues e.g., transperineal injection of a temporary rectal spacer gel between the prostate and rectum. Some patients may receive specific instructions for bowel and bladder preparation before radiation treatment to ensure consistent positioning of these organs during therapy and to achieve the planned radiation dose distribution. Written information may be useful to achieve this consistency, see eviQ patient information sheet Preparing your bladder and bowel for pelvic radiation therapy.

• #9 Laparoscopic insertion of pelvic tissue expander to prevent radiation enteritis prior to radiotherapy for prostate cancer | Radiation Oncology | Full Text

  https://ro-journal.biomedcentral.com/articles/10.1186/1748-717X-6-47

  Methods of reducing injury to small bowel include multi-field conformal therapy with prior three dimensional planning where the profile of the radiation beam is shaped to fit the target. […] If available, brachytherapy or cryotherapy may be reasonable alternatives to external beam radiotherapy. […] Where external beam radiotherapy is the preferred or only option, various methods for removing small bowel from the radiation field exist. […] Normal saline filled silicone tissue expanders are easy to insert and remove and have the benefit of being non-adherent to both peritoneum and small bowel, as well as radioresistant to degradation, and when filled with normal saline, are similar in density to human tissues, therefore do not alter the isodose distribution of radiotherapy. […] The ease, simplicity, reversibility, and minimally invasive nature of laparoscopic tissue expander insertion are its main appeal. It should be considered as an option for excluding small bowel from the pelvis prior to radiotherapy of the prostate.

• #10 Pharmacological interventions for the prevention and treatment of radiation colitis, enteritis and proctitis – Ali, S – 2011 | Cochrane Library

  https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008971/full

  PREVENTION: Most advancements made in the prevention of radiation injury are nonpharmacologic and include reducing the dosage of radiation (also known as intensity modulated radiotherapy) reducing the area of intestinal exposure to radiotherapy, multiple field arrangement and conformal radiotherapy techniques (three dimensional radiotherapy). These techniques have been relatively successful with a 25-40% reduction in both acute and chronic gastrointestinal toxicity. Other nonpharmacologic or physical measures include belly boards, surgical placement of an intestinal sling, bladder distention during treatment, insertion of absorbable mesh slings and breast prosthesis. These interventions are aimed at excluding the small bowel from the area of radiation, thereby reducing toxicity. Results are varied and where the absorbable mesh and the breast prosthesis have shown some promise, most other techniques and their results are not reproducible (Chen 1992; Cho 1995; Dasmahapatra 1991; Durig 1984; Gallagher 1986; Gaurd 1986; Heemsbergen 2005; Herbert 1993; Letschert 1990; Meric 1994; Rodier 1991; Sezeur 1999; Shanahan 1990; Waddell 1999).

• #11 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.

• #12

  https://link.springer.com/article/10.1007/s11894-002-0005-3

  Measures to minimize small intestine injury in the irradiated pelvis. […] Efficacy of a belly board device with CT-simulation in reducing small bowel volume within pelvic irradiation fields. […] Prophylaxis against radiation injury: the use of elemental diet prior to and during radiotherapy for invasive bladder cancer and in early postoperative feeding following radical cystectomy and ileal conduit.

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

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

  Prebiotics (eg, inulin and fructo-oligosaccharide) have been suggested as a possible means of helping to prevent acute radiation enteritis in patients with gynecologic cancer. […] Scartoni et al found that a zinc-based nutritional supplement to which prebiotics, tyndalized probiotics, and vitamins had been added was a safe and feasible means of protecting against radiation-induced diarrhea in patients undergoing pelvic RT. […] A study by Yan et al found that in patients receiving intensity-modulated RT (IMRT) for gynecologic cancer (N = 60), exposure of the small intestine to radiation was less when IMRT was delivered with the patient prone (n = 34) than when it was delivered with the patient supine (n = 26).

• #14 Laparoscopic insertion of pelvic tissue expander to prevent radiation enteritis prior to radiotherapy for prostate cancer | Radiation Oncology | Full Text

  https://ro-journal.biomedcentral.com/articles/10.1186/1748-717X-6-47

  Radiation enteritis is a significant complication of external beam radiotherapy (EBRT) to the pelvis, particularly in patients having high dose radiotherapy (80 Gy) and in those with a low pelvic peritoneal reflection allowing loops of small bowel to enter the radiation field. […] Laparoscopic insertion and subsequent removal of a pelvic tissue expander before and after external beam radiotherapy is a relatively convenient, safe and effective method for displacing loops of bowel out of the pelvis. […] Laparoscopic insertion and subsequent removal of a tissue expander before and after radiotherapy is a relatively convenient and minimally invasive procedure that may be an option for displacing loops of bowel from the radiation field. […] Any patient having external beam pelvic radiotherapy should have a planning CT, with particular attention given to those patients with a low peritoneal reflection, and loops of bowel within the planned radiation field.

• #15

  https://link.springer.com/article/10.1007/s11894-002-0005-3

  The frequent use of radiotherapy for abdominal and pelvic malignancies results in an increased risk of radiation enteritis. An increased understanding of the tissue response and the clinical features of radiation enteritis has led to advances in the prevention and management of this condition. Importantly, improvements in the delivery of radiotherapy, including techniques to reduce the amount of exposed small intestine in the radiation field, represent a critical strategy for prevention. […] Data indicate that radioprotectant agents have the potential to reduce intestinal mucosal injury and may be beneficial in reducing both acute and chronic side effects of radiotherapy. […] An important study showing reduction of radiation injury with sulfasalazine. […] Prevention of radiation enteritis by an absorbable polyglycolic acid mesh sling: a 60 case multicenter study.

• #16 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. Grade of Recommendation: Strong recommendation based on low-quality evidence, 1C. […] In the early 1990s, studies emerged describing methods to exclude the small bowel from the pelvis and to decrease the incidence of radiation enteritis. The first such study was a multicenter trial from Europe describing a mesh sling to exclude the small bowel from the pelvis before radiation. […] As radiation techniques have become more precise, it is thought that these adjuncts are not necessary to reduce complications.

• #17 Radiation Enteropathy – Pathogenesis, Treatment, and Prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4346191/

  The risk of radiation enteropathy limits the uncomplicated cancer cure rate and adversely impacts the quality of life of cancer survivors. […] The management of acute radiation enteropathy remains largely symptomatic and follows guidelines for treating similar symptoms in other situations. […] Evidence-based reviews of strategies to minimize early and/or delayed radiation enteropathy have been published, for example, by the Multinational Association of Supportive Care in Cancer (MASCC). […] Many natural products, peptides, and small molecules have been tested preclinically for the purpose of preventing, mitigating (strategies that are applied after irradiation, but before symptoms occur), and treating radiation enteropathy. […] The second, fundamentally different approach consists of agents that modulate various pathophysiological, cellular, or molecular responses that occur downstream from radiation.

• #18 Pharmacological interventions for the prevention and treatment of radiation colitis, enteritis and proctitis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6464563/

  Probiotics are live microorganisms that, when administered in adequate amounts may confer a health benefit to the host. The role of probiotics has been evaluated in the prevention of radiation induced diarrhea. […] Misoprostol is a prostaglandin E1 analogue, which has cytoprotective effects and works by promoting mucosal blood flow. Misoprostol rectal suppositories may be useful for the prevention of acute and chronic symptoms of radiation proctopathy.

• #19 Pharmacological interventions for the prevention and treatment of radiation colitis, enteritis and proctitis – Ali, S – 2011 | Cochrane Library

  https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008971/full

  Amongst the pharmacologic therapies, aminosalicylic acid derivatives, sucralfate preparations and nutritional therapies are the most studied. Pravastatin and simvastatin have been shown to protect against delayed enteropathy in rats (Haydont 2007). Similarly, teduglutide, a glucagon-like peptide-2 analogue, increases intestinal crypt stem cell survival in mice, when given before full body radiation (Booth 2004). Only a few controlled trials exist in humans. […] PREVENTION: Aminosalysilic acid derivatives: Aminosalicylates include sulfasalazine and mesalamine and are administered orally or per rectum; as suppositories or enemas. These are anti-inflammatory medications which work by a variety of mechanisms, including inhibition of prostaglandin synthesis, promotion of endogenous cytoprotective prostaglandins, inhibition of leukotriene A4 to leukotriene B4 transformation, scavenging of oxygen radicals and alteration of bacterial flora. These agents have been used for the prevention of radiation injury including proctitis (Kilic 2000; Baughan 1993; Resbeut 1997; Jahraus 2005).

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

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

  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. The commonly used methods of prevention include the following: […] 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; intracellular oxidation of WR-1065 yields active metabolites that protect the cell by scavenging free radicals and stabilizing the DNA; 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; it has also been used as an intrarectal foam enema (ProctoFoam) with variable results.

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

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

  Radiation therapy is used in curative, palliative, and prophylactic treatment plans, and is delivered through external beam, internal placement, or systemic administration, depending on the type of cancer and treatment goals. […] Careful treatment planning, including the use of radiosensitizers and radioprotectants, aims to limit radiation exposure to noncancerous cells, thus limiting adverse effects. […] Adding dexamethasone (4 mg daily for five days) to ondansetron therapy provides additional prophylaxis against radiation-induced emesis. […] Oral sulfasalazine (Azulfidine) is effective in the prevention of proctitis in all patients receiving pelvic radiation. […] Hyperbaric oxygen therapy significantly improved healing responses in patients with refractory radiation proctitis in a study of 120 patients (number needed to treat = 3).

• #22

  https://journals.lww.com/ajg/fulltext/2004/10001/prevention_of_acute_radiation_enteritis_in.867.aspx

  Patients receiving radiotherapy (RT) for pelvic cancers frequently experience acute radiation enteritis (ARE). […] A newer generation 5-ASA agent, balsalazide (BSZ) has a unique delivery system, similar to sulfasalazine, the only other effective agent in ARE. […] Patients were administered 2250 mg BSZ or an identical-appearing placebo twice daily beginning 5 days prior to RT, and continuing for 2 weeks after completion. […] Proctitis was prevented most effectively with a symptom index of 40.78 in BSZ patients and 74.08 in placebo patients. […] BSZ has the potential to limit major toxicities caused by radiotherapy of the pelvis.

• #23 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. […] Antioxidant administration during radiotherapy has been shown to increase efficacy and decrease the side effect profile. […] Patients should maintain adequate hydration and avoid foods that cause discomfort. The risk of malignancy and recurrence should be conveyed and watched for during follow-up visits.

• #24 Proctitis

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

  Attempts to use adjunctive medical therapy to prevent radiation proctitis have shown benefit in small trials, reducing symptoms of both acute and chronic radiation proctitis. The Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO) clinical practice guidelines for the management of mucositis secondary to cancer therapy recommend intravenous amifostine for preventing radiation proctitis. […] Several interventions have been trialled in patients receiving pelvic irradiation to either prevent or control gastrointestinal symptoms which can be caused by radiation proctitis or from more proximal bowel damage. The MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy provide recommendations and suggestions for the use of medications to manage diarrhoea from radiation-induced proctitis. Dietary interventions that have been investigated include lactose restriction, fat restriction or modification and fibre supplementation. Although no specific treatments have been recommended, there is some evidence that dietary modification may reduce acute symptoms of diarrhoea in patients receiving pelvic irradiation.

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

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

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

  Radiation-induced diarrhea can be severe and life threatening. 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. It is also expected that effective management/prevention of severe diarrhea would avoid hospitalization for complications such as dehydration, fluid and electrolyte imbalance, or nutritional decline. […] 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.

• #27 Pharmacological interventions for the prevention and treatment of radiation colitis, enteritis and proctitis – Ali, S – 2011 | Cochrane Library

  https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008971/full

  Sucralfate preparations: Sucralfate preparations may be given orally or in suspension enema forms. There are anti-inflammatory agents which adhere to mucosal cells and exert their cytoprotective effects. They stimulate prostaglandin synthesis, promote local blood flow and increase the local production of epidermal growth factor. Sucralfate has been used for the prevention of proctocolitis (O’ Brien 1997; Henriksson 1992). […] Nutritional therapies: Nutritional therapies rich in glutamine, Arginine and Vitamin E have shown a protective effect on the intestinal mucosa in rats. Nutritional therapy has been evaluated as prevention therapy (Kozelsky 2003; Jenson 1994). […] Probiotics: Probiotics are live microorganisms that, when administered in adequate amounts may confer a health benefit to the host. The role of probiotics has been evaluated in the prevention of radiation induced diarrhea (Delia 2002; Salminen 1988). […] Misoprostol: Misoprostol is a prostaglandin E1 analogue, which has cytoprotective effects and works by promoting mucosal blood flow. Misoprostol rectal suppositories may be useful for the prevention of acute and chronic symptoms of radiation proctopathy (Khan 2000).

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

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

  Patients undergoing radiation therapy should avoid swimming, especially in chlorinated pools and hot tubs, and use care when applying adhesive bandages on skin in the radiated field. […] 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.

• #29 (PDF) REVIEW ARTICLE ON RADIATION-INDUCED PROCTITIS & ENTERITIS

  https://www.academia.edu/84046040/REVIEW_ARTICLE_ON_RADIATION_INDUCED_PROCTITIS_and_ENTERITIS

  Moreover, new insight into the underlying pathophysiology have resulted in an improved understanding of mechanisms of radiation-induced bowel toxicity and in development of new diagnostic strategies and management opportunities. […] Treatment options include initial conservative medical therapies, endoscopic procedures, hyperbaric oxygen and surgery. Some pharmacological agents to prevent gastrointestinal toxicity are under investigation. […] Antiplatelet agents such as ticlopidine and clopidogrel were shown to prevent CRE and this effect is believed to be directed by their activities against thrombocytes. […] Assuming that radiation induced apoptosis occur 6-10 h after irradiation, we think that timing of these antiaggregant drugs with irradiation is important and a 6-10 h interval between these may be beneficial to avoid this adverse interaction.

• #30 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 un sujeto 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.

• #31 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. […] La rifaximina se puede administrar antes, durante y/o después de las terapias de tratamiento. […] Sujetos en necesidad de la misma incluyen los sujetos que serán sometidos a terapia de radiación, ya sea sola o en combinación con otras terapias pélvicas que podrían inducir enteritis o inflamación de porciones del tracto digestivo. […] La „prevención” incluye la protección contra la enteritis inducida por radiación. […] La invención descrita en esta memoria también es útil para la protección de un sujeto frente a la enteritis inducida por radiación mediante la administración a un sujeto en necesidad de la misma una cantidad terapéuticamente eficaz de rifaximina.

• #32 Radiation enteritis

  https://adamcertificationdemo.adam.com/content.aspx?productid=140&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. […] 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.

• #33 Enteritis and cancer | EBSCO Research Starters

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

  Radiation enteritis is caused by radiation therapy to the abdomen, pelvic area, or rectum. […] Generally, the higher the dose and frequency of radiation and the larger the amount of intestine exposed, the more likely the individual is to develop radiation enteritis. […] Nutritional counseling and a modified diet can help reduce some symptoms of the disorder.

• #34 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. […] Given the role of the microbiome in radiation enteritis, we suggest that the gut microbiota may be a potential biomarker for the disease. 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. […] Probiotics and prebiotics have been widely used in the prevention and treatment of important gastrointestinal diseases such as irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) and infectious diarrhea. 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.

• #35 The Prophylactic Use of Probiotics in the Prevention of Radiation Therapy-Induced Diarrhea | Oncology Nursing Society

  https://cjon.ons.org/publications-research/cjon/14/4/prophylactic-use-probiotics-prevention-radiation-therapy-induced

  Cancer treatment regimens that include radiation therapy (RT) to the abdominal region for cervical, ovarian, prostate, sigmoid, or colorectal cancer potentially disturb the colonization resistance of the indigenous gut flora, causing RT-induced diarrhea, enteritis, and colitis in more than 80% of patients with cancer. One approach for the prevention of RT-induced diarrhea is the use of probiotics. Randomized clinical trials have demonstrated efficacy of probiotic preparations VSL #3 and Lactobacillus casei DN-114 001 in decreasing the incidence and grade of RT-induced diarrhea. […] Oncology nurses and advanced practice clinicians are in a position to interpret research findings related to RT-induced diarrhea, enteritis, and colitis and to apply evidence-based practice principles in patients with cancer receiving RT to promote positive outcomes.

• #36 Therapeutic role of glutamine in management of radiation enteritis: a meta-analysis of 13 randomized controlled trials | Oncotarget

  https://www.oncotarget.com/article/15741/text/

  Objective: To systematically evaluate the clinical efficacy of glutamine in treating radiation enteritis in cancer patients treated with radiotherapy. […] In cancer patients suffering from radiation enteritis, there is increasing need for development of effective and standard radio-protective regimens to recede or minimize the damage caused by radiation. […] Glutamine is one kind of neutral amino acid with the roles of providing energy source for intestinal endothelial cells and enhancing local bowel immune function. […] Adding external glutamine for patients with radiation enteritis is believed to be beneficial, with the strong evidence provided by the animal studies. […] However, available clinical data failed to demonstrate the beneficial effect of glutamine during pelvic radiotherapy.

• #37 Therapeutic role of glutamine in management of radiation enteritis: a meta-analysis of 13 randomized controlled trials | Oncotarget

  https://www.oncotarget.com/article/15741/text/

  In this study, we aimed to evaluate the role of glutamine, which has controversial efficacy, for improvement and management of radiation enteritis. […] 10 of the 13 studies identified administration of glutamine as beneficial for curing and preventing radiation enteritis, and the other 3 studies showed no significant effect of glutamine on radiation enteritis. […] Overall, the combined OR for all 7 studies evaluating administration of glutamine on treatment of radiation enteritis was 3.07(95%CI: 0.79-11.96; P0.05), suggesting that glutamine was beneficial for relieving radiation enteritis, however, there was no statistically significance. […] These results indicating that administration of glutamine failed to significantly reduce the grades of radiation enteritis. […] These findings suggested that the severity of abdominal cramping at any grade was not significantly benefited from treatment of glutamin.

• #38 Therapeutic role of glutamine in management of radiation enteritis: a meta-analysis of 13 randomized controlled trials | Oncotarget

  https://www.oncotarget.com/article/15741/text/

  These results suggested that glutamine did not significantly prevent or improve symptom of blood in bowel movement in terms of any grades. […] Glutamine is suggested to be a powerful agent in preventing and treating radiation enteritis as proved by several animal studies and few clinical studies, but it failed to gain the same effect in some clinical trials. […] Our data provided evidence to support the beneficial effect of supplements of glutamine in curing radiation enteritis and were consistent with the results of the clinical studies published in China, however, it lost its significance. […] In conclusion, our meta-analysis explored the efficacy of glutamine in preventing and treating radiation enteritis and relieving symptoms of radiation enteritis.

• #39

  https://link.springer.com/article/10.1007/s12094-011-0729-3

  Our primary endpoint is to determine the effect of L-glutamine Resource (Nestl Healthcare Nutrition) in the prevention of induced enteritis after pelvic radiotherapy (RT). […] Administration of glutamine to patients during pelvic RT does not appear to prevent the incidence of enteritis (diarrhoea). No differences were observed between patients who underwent concomitant chemotherapy (where you would expect an increase in toxicity) and those who did not.

• #40 Prevention of acute radiation enteritis: efficacy and tolerance of glutamine

  https://cgl.org.cn/auto/db/detail.aspx?db=706213&rid=1376613&agfi=0&cls=0&uni=True&cid=0&showgp=True&prec=False&md=93&pd=6&msd=93&psd=6&mdd=93&pdd=6&count=10&reds=jordan%3Bjaime

  Prevention of acute radiation enteritis: efficacy and tolerance of glutamine […] Purpose Our primary endpoint is to determine the effect of L-glutamine Resource (Nestl Healthcare Nutrition) in the prevention of induced enteritis after pelvic radiotherapy (RT). […] Conclusions Administration of glutamine to patients during pelvic RT does not appear to prevent the incidence of enteritis (diarrhoea).

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

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

  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. […] Studies have shown that FMT can relieve symptoms of radiation enteritis and improve gastrointestinal function.

• #42 The Role of Hyperbaric Oxygen as a Prophylaxis for Radiation Enteritis

  https://apps.dtic.mil/sti/html/tr/ADA274974/index.html

  C3H mice were used to study the effects of post radiation treatments of hyperbaric oxygen HBO on preventing onset of radiation enteritis. This study indicates that post-radiation HBO treatments can significantly reduce small bowel radiation damage in mice.

• #43 Enteritis: Definition, types, and prevention

  https://www.medicalnewstoday.com/articles/323218

  Radiation enteritis may occur as a result of radiation therapy. Radiation not only kills cancer cells, but healthy cells too, including the cells in the mouth, stomach, and bowel. […] There are several tips to help prevent food poisoning and enteritis, including practicing proper hygiene, food preparation, and cooking. […] Proper hydration is essential even in mild cases of enteritis, as well as for general health. […] People can take electrolyte solutions to prevent and treat dehydration. […] Anyone who develops radiation enteritis may need to reschedule or even discontinue their radiation treatment. […] In many cases, prevention of enteritis is possible by practicing good hygiene and handling food carefully.

• #44 Radiation Enteropathy – Pathogenesis, Treatment, and Prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4346191/

  The recent interest in finding so-called medical countermeasures against radiation (drugs for use in the radiological and nuclear emergency situation, where radiation injury to the bone marrow and intestine is the main determinant of survival) has spawned a resurgence in activities to find compounds to protect the intestine against radiation.

• #45 Soligenix Announces Results From Its Phase 1/2 Clinical Trial of SGX201 for the Prevention of Acute Radiation Enteritis – BioSpace

  https://www.biospace.com/soligenix-announces-results-from-its-phase-1-2-clinical-trial-of-sgx201-for-the-prevention-of-acute-radiation-enteritis

  Soligenix, Inc. (OTCBB: SNGXD) (Soligenix or the Company), a development stage biopharmaceutical company, announced preliminary results today from a Phase 1/2 clinical trial evaluating SGX201, a time-release formulation of oral beclomethasone 17,21-dipropionate (oral BDP), for the prevention of acute radiation enteritis. […] The primary objective of the study was to evaluate the safety and tolerability of escalating doses of SGX201, as well as to assess the preliminary efficacy of SGX201 for prevention of signs and symptoms of acute radiation enteritis. […] „Based on oral BDP’s proven pharmacology in treating severe gastrointestinal inflammation, SGX201 represents a potential prophylactic option that would enable physicians/patients to maintain planned treatment regimens to battle the underlying malignancy.” […] SGX201 has been awarded fast-track designation from the FDA for the prevention of radiation enteritis.

• #46 Soligenix Receives European Patents for Oral BDP in the Treatment of Acute Radiation Injury of the Gastrointestinal Tract

  https://www.prnewswire.com/news-releases/soligenix-receives-european-patents-for-oral-bdp-in-the-treatment-of-acute-radiation-injury-of-the-gastrointestinal-tract-300891946.html

  SGX201 has been awarded fast-track designation from the FDA for the prevention of radiation enteritis. […] OrbeShield has also been granted Orphan Drug and Fast Track designations by the FDA for the prevention of death following a potentially lethal dose of total body irradiation during or after a radiation disaster. […] The combination of immediate and delayed release oral BDP is also being developed as a treatment for Pediatric Crohn’s Disease in Soligenix’s SGX203 program, for which a pivotal Phase 3 clinical trial protocol has been agreed with U.S. Food and Drug Administration (FDA). […] There is an urgent need to develop specific medical countermeasures against the lethal consequences of radiation-induced GI injury.

• #47 Recent advances in the management of radiation colitis

  https://www.wjgnet.com/1007-9327/full/v14/i48/7289.htm

  Research to uncover the mechanisms of fibrosis and the molecular events underlying radiation bowel disease could lead to the development of new therapeutic and/or preventive approaches and provide the basis for predicting the risk of bowel damage and oncogenesis using levels and expressions of the mentioned cytokine IL-6, oncogene p53 or cadherin-catenin complexes, and for amelioration of bowel damage through inhibition, for example, of the COX-2 and Rho/Rho kinase pathways. […] Improvements in the delivery of radiotherapy, including techniques to reduce the amount of exposed intestine in the radiation field, also represent a critical strategy for prevention.

• #48 Radiation enteritis

  https://adamcertificationdemo.adam.com/content.aspx?productid=140&pid=1&gid=000300

  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.

• #49 (PDF) REVIEW ARTICLE ON RADIATION-INDUCED PROCTITIS & ENTERITIS

  https://www.academia.edu/84046040/REVIEW_ARTICLE_ON_RADIATION_INDUCED_PROCTITIS_and_ENTERITIS

  Radiation enteritis is becoming more common as more cancer patients receive radiotherapy and their long-term survival improves. […] Given the morbidity and mortality of chronic radiation enteritis, tissue-sparing irradiation treatments are examined. […] In conclusion, therapeutic and preventative methods for chronic radiation enteritis have minimal evidence, but an organized approach to studying gastrointestinal symptoms following irradiation might allow improved targeting of current medicines. […] Closer collaboration between oncologists and gastroenterologists will permit a more systematic approach to managing patients and building clinical and research networks for this increasing disease to strengthen its evidence basis. […] Significant progress toward reducing toxicity of radiation therapy has been made by the introduction of so-called dose-sculpting treatment techniques, which allow more precise delivery of the radiation beam.

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