Radiation proctitis overview

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Radiation proctitis Microchapters

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Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Radiation proctitis from other Diseases

Epidemiology and Demographics

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Natural History, Complications and Prognosis

Diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

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Overview

Radiation proctitis is inflammation and damage to the lower parts of the colon after exposure to x-rays or other ionizing radiation as a part of radiation therapy. Radiation proctitis most commonly occurs after treatment for cancers such as cervical cancer, prostate cancer, and colon cancer. Radiation proctitis involves the lower intestine, primarily the sigmoid colon and the rectum.

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Radiation proctitis overview from Other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications, and Prognosis

Natural History

Complications

Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Patients with radiation proctitis may appear pale and dehydrated. Some patients may appear fatigued and in distress, associated with abdominal pain.

Laboratory Findings

The laboratory findings in a patient with acute radiation proctitis can be within reference range however, in case of chronic injury anemia, elevated white blood cell, deranged LFTs and electrolyte abnormalities can be seen.

Imaging Findings

Barium studies can be done in patients who have obstructive symptoms or those suspected of having fistulas.

Other Diagnostic Studies

Other diagnostic studies such as colonoscopy, tissue biopsy and histological analysis can help with the diagnosis of radiation proctitis.

Treatment

Medical Therapy

Acute radiation proctitis is a self limiting condition and treated conservatively however in 20% of cases undergoing external beam radiation will require short interruptions in their treatment to improve symptoms.In case of chronic radiation proctitis treatment usually depends upon the severity and pattern of the symptoms.

Surgery

Surgery is not the first-line treatment option for patients with radiation proctitis.However it is usually reserved as a last resort for patients with refractory symptoms and complications.

Prevention

Primary prevention of radiation proctitis can be done by the modifications of radiation techniques and doses or by use of prophylactic adjunct medical and surgical therapies.

References

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