What are signs and symptoms of Radiation Enteritis?

Signs and symptoms of Radiation Enteritis include: - Diarrhea, which is the most common symptom and can occur with or without abdominal pain. - Abdominal pain. - Bleeding within the intestine. - Blockages in the intestine. - Tears or holes in the wall of the intestine. - Abnormal connections (fistulas) between different parts of the intestine or between the intestine and other organs. - Difficulty in absorbing nutrients from food (malabsorption). - Pain in the rectum. - Rectal bleeding due to sores (ulcers).

How do you get Radiation Enteritis?

Radiation enteritis can develop based on factors such as the duration of treatment, the radiation dose, and the sensitivity of the gut to radiation.

What else can Radiation Enteritis be?

The other conditions that a doctor needs to rule out when diagnosing Radiation Enteritis are: - Bowel infection - New or recurring cancer - An overgrowth of bacteria in the small intestine - Pancreatic insufficiency - Inflammatory bowel disease that has recently begun

What kinds of test are needed for Radiation Enteritis?

The types of tests that may be needed for Radiation Enteritis include: - Breath test to check for bacterial overgrowth in the gut - CT scan or MRI to detect changes in the body - Endoscopic evaluation to examine the intestines with a camera - PET-CT scan to obtain detailed images after radiation therapy - Checking for tumor markers in the blood 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. In some cases, surgery may be required to address complications like intestinal strictures, fistulas, or perforations.

How is Radiation Enteritis treated?

Radiation enteritis is treated by managing the symptoms and complications caused by radiation exposure. Symptoms such as diarrhea can be improved by drinking fluids and taking medication. To manage bacterial overgrowth, oral antibiotics may be prescribed. Vitamins and electrolytes may also be provided if necessary. In cases of malabsorption, the patient's nutritional status will be monitored. Treatment for radiation proctitis and tenesmus may include enemas to soothe and protect the intestines. 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.

What are the side effects when treating Radiation Enteritis?

The side effects when treating Radiation Enteritis can include diarrhea, bacterial overgrowth in the gut, malabsorption of nutrients, mild bleeding, and minor symptoms.

Are there long term effects of Radiation Enteritis?

The prognosis for Radiation Enteritis depends on several factors, including the dosage of radiation received, previous abdominal surgery, body mass index, existing health conditions like diabetes and high blood pressure, and undergoing chemotherapy at the same time. Statistics show that many patients who have surgery due to damage in their gut caused by radiation therapy pass away from their original cancer within a two-year period. However, when the cancer doesn't return, the survival rate is about 70% five years after diagnosis.

Radiation Enteritis

What is Radiation Enteritis?

Radiation enteritis is a condition where the small and/or large intestines get damaged due to radiation exposure. Sometimes, it’s called by other names like radiation colitis, radiation enteropathy, radiation mucositis, or pelvic radiation disease. There’s a more specific term, radiation proctitis, which refers to when this damage affects the rectum and sigmoid colon – these are parts of your large intestine. It’s important to know that radiotherapy, a common treatment for various types of cancer, can cause radiation enteritis. This condition can develop either shortly or long after treatment – anywhere from 3 months to even 30 years post-treatment.

What Causes Radiation Enteritis?

Radiation enteritis is a common but unpredictable side effect of radiation therapy. It can develop in different ways based on factors such as how long the treatment lasts, the dose of radiation, and the sensitivity of your gut to radiation.

Risk Factors and Frequency for Radiation Enteritis

Radiation enteritis is fairly widespread, resulting in lasting changes in bowel habits for around 90% of people who undergo pelvic radiotherapy. Evidence indicates that it tends to be more prevalent in those receiving radiation therapy for gastrointestinal (GI) and gynecologic tumors as opposed to urological tumors. Chronic radiation enteritis develops in roughly 5% to 55% of patients after they’ve received radiotherapy.

Signs and Symptoms of Radiation Enteritis

Diarrhea is the most common symptom of this condition, and it can occur with or without abdominal pain. A variety of other symptoms can also occur, including:

Abdominal pain
Bleeding within the intestine
Blockages in the intestine
Tears or holes in the wall of the intestine
Abnormal connections (fistulas) between different parts of the intestine or between the intestine and other organs
Difficulty in absorbing nutrients from food (malabsorption)
Pain in the rectum
Rectal bleeding due to sores (ulcers)

Testing for Radiation Enteritis

If you have symptoms like diarrhea, stomach pain, or a feeling of fullness, your doctor may recommend a breath test. This test can help find out if there’s an overgrowth of bacteria in your gut.

Your doctor may also recommend a CT scan or MRI. These imaging tests can show changes in your body that can’t be seen with traditional imaging methods. A thing to note, a pill enterography, a diagnostic test using a camera pill, might not be the best choice as there are chances of the pill getting stuck. On the other hand, your doctor might opt for an endoscopic evaluation. Endoscopy is a procedure where a thin tube with a camera is inserted into the body to look inside. This is considered if there’s a possibility of surgical connection in the colon. The doctor will also try to mark the affected parts of the intestines to match the imaging results with your symptoms.

There are various scoring systems to rate the severity of symptoms for patients undergoing radiation treatment. However, none of these have been successful in achieving this goal.

After radiation therapy, doctors should actively monitor for any signs that the cancer might have come back. This could involve using a PET-CT scan, which combines PET and CT scans to provide more detailed images, and checking for tumor markers, substances that are produced by some cancer cells and can be found in the blood.

Treatment Options for Radiation Enteritis

Acute radiation enteritis refers to inflammation and damage to the intestines caused by radiation exposure. Its symptoms are usually temporary and can often improve within weeks by drinking lots of fluids and taking medication to treat the diarrhea caused by the condition. It is rare that surgery would be required for this condition.

There is evidence suggesting that taking antioxidants while receiving radiation therapy might make the treatment more effective and decrease its side effects. To manage bacterial overgrowth in the gut, which can sometimes follow acute radiation enteritis, doctors usually prescribe oral antibiotics. They might also provide vitamins and electrolytes, if necessary, to help the patient’s body function properly.

If the patient isn’t eating enough or if their body isn’t absorbing nutrients properly (malabsorption), the doctor will likely monitor their nutritional status. However, even if the patient has mechanical malabsorption – where the physical process of digestion or absorption is disrupted – surgery might not alleviate the symptoms. Mild bleeding and minor symptoms don’t typically call for further treatment.

In the case of radiation proctitis and tenesmus – inflammation and discomfort in the rectum and difficulty in passing stool respectively – treatment often includes enemas, such as a sucralfate enema which can help to soothe and protect the lining of the intestines.

Long term exposure to radiation can sometimes lead to serious complications like intestinal strictures (narrowing), fistulas (abnormal connections between organs), and perforations (holes) in the intestines, which usually require surgical intervention. 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). The study also found that multiple surgeries didn’t necessarily lead to more health issues, known as morbidity. It’s deemed beneficial to remove all irradiated sections of the bowel in the initial operation to potentially limit the need for further surgeries. But this isn’t always an option, as removing too much intestinal tract can result in a complication called short bowel syndrome, where the body can’t absorb enough nutrients from food.

If you have symptoms that are similar to radiation enteritis, your doctor might consider several other possible conditions. These could include:

Bowel infection
New or recurring cancer
An overgrowth of bacteria in your small intestine
Pancreatic insufficiency, where your pancreas is not producing enough enzymes
Inflammatory bowel disease that has recently begun

Surgical Treatment of Radiation Enteritis

It’s often less helpful to only remove the scar tissue (adhesiolysis) or to create a route that circumvents (bypasses) the problem area in the bowels. In most cases, taking out the entire diseased portion of the bowel offers the best chance for improvement.

What to expect with Radiation Enteritis

Radiation enteritis, a condition that causes damage to the intestines as a result of radiation therapy, can be influenced by various factors. These factors include the dosage of radiation received, having had previous abdominal surgery, the individual’s body mass index (which is a measure of body fat based on height and weight), existing health conditions like diabetes and high blood pressure, as well as undergoing chemotherapy at the same time.

Statistics reveal that many patients who have surgery due to damage in their gut caused by radiation therapy, end up passing away from their original cancer within a two-year period. However, when the cancer doesn’t return, the survival rate is about 70% five years after diagnosis.

Possible Complications When Diagnosed with Radiation Enteritis

Current research indicates that exposure to radiation in the pelvic region can increase the risk of developing cancer over time.

Recovery from Radiation Enteritis

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.
Intra-abdominal abscess: This is a pocket of pus that forms inside the abdominal cavity.
External fistula: This is an abnormal opening or passage between two organs or between an organ and the skin.
Postoperative fistula: Similar to an external fistula, this is an abnormal passage that develops after surgery.
Postoperative peritonitis: This is an inflammation of the peritoneum, the lining of your abdomen, that can occur after surgery.

Preventing Radiation Enteritis

Patients should make sure to drink plenty of fluids and steer clear of foods that make them uncomfortable. The doctor should explain the potential risks of the illness returning or becoming more serious. These possibilities should be monitored during future check-ups.