Definition Radiation enteritis is a complication of radiation therapy to the abdomen or pelvis. Radiation therapy is sometimes used to treat certain diseases, especially cancers. In addition to killing cancer deep in the body, it damages the healthy tissue around it, like the bowels. The damage may occur at the time of treatment or take many years to develop.
What is going on in the body? Radiation therapy is a form of energy carefully directed at cancerous tissue. This energy is powerful enough to kill cancer cells deep in the body. All tissues overlying the cancer also are affected. For instance, radiation therapy used to treat bowel cancer, ovarian cancer, or prostate cancer often severely damages healthy tissue, like the bowels.
The bowels, also called the intestines, are very sensitive to radiation therapy. As a result, the blood supply to the bowels can become impaired. With a poor blood supply, the affected bowel will be weakened. In fact, that part of the bowel may die.
Scarring of the bowel sometimes happens. When this occurs, the bowel will not work properly. Intestinal obstructions may form as a result of the scar tissue.
What are the signs and symptoms of the disease? Acute symptoms of radiation enteritis occur during and right after radiation therapy to any cancer of the abdomen or pelvis. They include:
Sometimes an intestinal obstruction will form that will cause severe nausea and vomiting. A fistula, or abnormal opening from one part of the bowel to another organ, may also occur.
What are the causes and risks of the disease? Radiation enteritis is caused by radiation treatment to the abdomen and pelvis.
What can be done to prevent the disease? It is very difficult to prevent radiation enteritis when radiation therapy is used. Effectively treating the cancer is the most important goal. Large doses of radiation may be needed to kill the cancer.
How is the disease diagnosed? A person undergoing radiation therapy is observed closely for signs of radiation enteritis. The problem is identified when symptoms are reported.
What are the long-term effects of the disease? Acute radiation enteritis usually resolves without lasting effects. Chronic radiation enteritis occurring many years after treatment is harder to treat. If it is not severe, the problems can be managed with changes in diet and other interventions. The damage may be so extensive that the person will have to undergo surgery to remove the affected bowel or to repair an opening from the bowel to another organ.
What are the risks to others? Radiation enteritis poses no risk to others.
What are the treatments for the disease? In acute cases of radiation enteritis, diarrhoea and nausea can often be controlled with medications. Not treating the diarrhoea effectively can result in dehydration. A person may have to be admitted to the hospital in severe cases. A diet that is low in fibre is helpful. Resting will help the person conserve energy while the bowel is healing.
In chronic cases, the person may have to have surgery to remove blockages or scar tissue in the bowel. Diarrhoea is likely to be a long-term problem. Medications, such as psyllium, will give the stool a firmer consistency. The person will have to focus on eating foods that do not make the diarrhoea worse or cause cramping.
What are the side effects of the treatments? Bowel surgery is major surgery and requires a recovery period. Repairing a bowel opening may also entail surgery. Other therapy is designed to improve quality of life and does not generally have significant side effects.
What happens after treatment for the disease? The person will be monitored for return of symptoms or development of new problems. Follow-up visits will include discussing any new symptoms. Any new or worsening symptoms should be reported to the doctor.
How is the disease monitored? Careful follow-up is the most effective way to monitor for the development of radiation enteritis. There is no routine test done that can diagnose this condition. Treating the symptoms before the person becomes weakened is important. Reporting symptoms right away to the doctor will help prevent problems.
Author: Thomas Fisher, MD Reviewer: eknowhow Medical Review Panel Editor: Dr John Hearne Last Updated: 5/02/2005 Contributors Potential conflict of interest information for reviewers available on request
