Radiation proctitis history and symptoms: Difference between revisions

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{{CMG}}; {{AE}}  
{{CMG}}; {{AE}}  
==Overview==
==Overview==
The most common symptoms of radiation proctitis include mild [[diarrhea]], [[tenesmus]], fecal urgency and mucus discharge. Less common symptoms of radiation proctitis include [[abdominal pain]],[[constipation]],severe diarrhea and rectal bleeding.<ref name="pmid8677984">{{cite journal| author=Babb RR| title=Radiation proctitis: a review. | journal=Am J Gastroenterol | year= 1996 | volume= 91 | issue= 7 | pages= 1309-11 | pmid=8677984 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8677984  }}</ref>
The most common symptoms of radiation proctitis include mild [[diarrhea]], [[tenesmus]], fecal urgency and mucus discharge. Less common symptoms of radiation proctitis include [[abdominal pain]], [[constipation]], severe [[diarrhea]] and rectal bleeding.


==History and Symptoms==
==History and Symptoms==
===History===
===History===
History plays a pivotal role in diagnosing the Radiaition proctitis and to exclude other differentials therefore history should include:
History plays a pivotal role in diagnosing the radiaition proctitis and to exclude other differentials therefore history should include:<ref name="pmid8677984">{{cite journal| author=Babb RR| title=Radiation proctitis: a review. | journal=Am J Gastroenterol | year= 1996 | volume= 91 | issue= 7 | pages= 1309-11 | pmid=8677984 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8677984  }}</ref>
 
*Exposure to the radiation
*Exposure to the radiation
*Recent hx of travel
*Recent history of travel
*Recent parasitic infection
*Recent [[parasitic infection]]
*History or risk factors for [[Sexually transmitted disease|STD]]
*History or risk factors for [[Sexually transmitted disease|STD]]
*Recent use of [[Antibiotic|antibiotics]] or [[Non-steroidal anti-inflammatory drug|NSAIDS]]
*Recent use of [[Antibiotic|antibiotics]] or [[Non-steroidal anti-inflammatory drug|NSAIDS]]
*History of atherosclerosis
*History of [[atherosclerosis]]
*Immunosuppression
*[[Immunosuppression]]


===Common Symptoms===
===Common Symptoms===
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===Less Common Symptoms===
===Less Common Symptoms===
Less common symptoms of radiation proctitis include  
Less common symptoms of radiation proctitis include  
*Abdominal pain
*[[Abdominal pain]]
*[[Constipation]]
*[[Constipation]]
*Severe Diarrhea
*Severe [[diarrhea]]
*Rectal bleeding
*Rectal bleeding


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===Chronic radiation proctitis===
===Chronic radiation proctitis===
[[Image:Radiation proctitis APC.jpg|center|thumb|200px|[[Colonoscopy|Endoscopic]] image of radiation proctitis before and after therapy with [[argon plasma coagulation]].]]
Symptoms may begin as early as several months after therapy but occasionally not until several years later. These symptoms include diarrhea, [[Hematochezia|rectal bleeding]], painful defecation, and intestinal blockage. Intestinal blockage is a result of [[Stenosis|narrowing]] of the rectum which blocks the flow of [[feces]] due to stricture and results in symptoms in the form of [[constipation]], rectal pain, urgency, and rarely [[fecal incontinence]] due to overflow. Connections [[fistulae]] may also develop between the colon and other parts of the body such as the [[skin]] or [[urinary system]]. Inury to the nearby organs can lead to [[cystitis]], urethral stenosis, [[small bowel obstruction]] and [[Small intestinal bacterial overgrowth syndrome|small bowel bacterial overgrowth]].
Symptoms may begin as early as several months after therapy but occasionally not until several years later. These symptoms include diarrhea, [[Hematochezia|rectal bleeding]], painful defecation, and intestinal blockage. Intestinal blockage is a result of [[Stenosis|narrowing]] of the rectum which blocks the flow of [[feces]] due to stricture and results in symptoms in the form of constipation,rectal pain,urgency, and rarely, fecal incontinence due to overflow. Connections [[fistulae]] may also develop between the colon and other parts of the body such as the [[skin]] or [[urinary system]].Inury to the nearby organs can lead to [[cystitis]],urethral stenosis,small bowel obstruction and small bowel bacterial overgrowth.
<br />[[Image:Radiation proctitis APC.jpg|center|thumb|200px|[[Colonoscopy|Endoscopic]] image of radiation proctitis before and after therapy with [[argon plasma coagulation]].]]
<br />


==References==
==References==

Revision as of 23:26, 6 November 2019

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

Overview

The most common symptoms of radiation proctitis include mild diarrhea, tenesmus, fecal urgency and mucus discharge. Less common symptoms of radiation proctitis include abdominal pain, constipation, severe diarrhea and rectal bleeding.

History and Symptoms

History

History plays a pivotal role in diagnosing the radiaition proctitis and to exclude other differentials therefore history should include:[1]

Common Symptoms

Common symptoms of Radiation proctitis include:

  • Changes in bowel habits,usually mild diarrhea
  • Tenesmus
  • Fecal urgency
  • Mucus discharge

Less Common Symptoms

Less common symptoms of radiation proctitis include

Acute radiation proctitis

Symptoms occur in the first few weeks after therapy. These symptoms include diarrhea and the urgent need to defecate, often with inability to do so (tenesmus). Acute radiation proctitis usually resolves without treatment after several months, but symptoms may improve with butyrate enemas. This acute phase is due to direct damage of the lining (epithelium) of the colon. [2]

Chronic radiation proctitis

Symptoms may begin as early as several months after therapy but occasionally not until several years later. These symptoms include diarrhea, rectal bleeding, painful defecation, and intestinal blockage. Intestinal blockage is a result of narrowing of the rectum which blocks the flow of feces due to stricture and results in symptoms in the form of constipation, rectal pain, urgency, and rarely fecal incontinence due to overflow. Connections fistulae may also develop between the colon and other parts of the body such as the skin or urinary system. Inury to the nearby organs can lead to cystitis, urethral stenosis, small bowel obstruction and small bowel bacterial overgrowth.


Endoscopic image of radiation proctitis before and after therapy with argon plasma coagulation.


References

  1. Babb RR (1996). "Radiation proctitis: a review". Am J Gastroenterol. 91 (7): 1309–11. PMID 8677984.
  2. Babb RR. Radiation proctitis: a review. Am J Gastroenterol. 1996 Jul;91(7):1309-11. Review. PMID 8677984

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