Overview
Radiation enteritis is inflammation of the intestines that occurs after radiation therapy. This condition typically affects people receiving radiation aimed at the abdomen, pelvis, or rectum. Radiation enteritis causes symptoms such as diarrhea, nausea, vomiting, and stomach cramps. For most individuals, the inflammation subsides several weeks after treatment ends. However, in some cases, radiation enteritis may continue long after radiation therapy or develop months or years after treatment. Chronic radiation enteritis can result in complications like anemia, diarrhea, or bowel obstruction. Treatment mainly focuses on relieving symptoms until the inflammation heals, and in severe cases, tube feeding or surgery to remove sections of the intestine may be necessary.
Understanding the disease
Symptoms
The symptoms of radiation enteritis include diarrhea, nausea, vomiting, and stomach cramps. These symptoms occur because of the irritation of the intestines caused by radiation therapy for cancer. Symptoms usually go away several weeks after treatment ends, but sometimes they can last longer, leading to complications such as anemia, diarrhea, or bowel obstruction.
Risk Factors
The risk factors for developing radiation enteritis include receiving radiation therapy aimed at the abdomen, pelvis, or rectum for cancer treatment. This condition is more common in people undergoing radiation therapy for cancers in the abdomen and pelvic areas. Other risk factors may include a weakened immune system, chronic kidney disease, and procedures on the digestive tract or other surgery in the stomach area.
Development
Radiation enteritis develops when the intestines become inflamed after radiation therapy. This inflammation can cause symptoms such as diarrhea, nausea, vomiting, and stomach cramps. Radiation enteritis typically occurs in people receiving radiation therapy for cancer in the abdomen, pelvis, or rectum areas. In most cases, the inflammation subsides several weeks after treatment ends. However, for some individuals, radiation enteritis may persist long after the therapy is completed or develop months or years after treatment. In severe cases, it can lead to complications like anemia, diarrhea, or bowel obstruction. Treatment for radiation enteritis focuses on relieving symptoms and allowing the inflammation to heal. In extreme cases, tube feeding or surgery to remove sections of the intestine may be necessary.
Assessment and Diagnosis
Triage
You should see a doctor if you have radiation enteritis symptoms and:
- Experience diarrhea for more than 24 hours
- Vomit frequently
- Have black or tarry stool or stool containing blood or pus
- Have a temperature of 102 F (38.9 C) or higher
- Seem tired, irritable, or in pain
- Show signs or symptoms of dehydration, including dry mouth, crying without tears, little or no urination, unusual sleepiness, or unresponsiveness For adults, consult your doctor if you can't keep liquids down for 24 hours, have diarrhea for more than two days, or have blood in your vomit or bowel movements. Remember that these symptoms may be indicative of a more severe case of radiation enteritis or another medical issue, so it's essential to seek medical advice.
Diagnosis
To diagnose radiation enteritis, your health care provider may start with a discussion of your medical history and a physical exam. Additional tests may include endoscopy, colonoscopy, capsule endoscopy, X-rays, CT scan, or MRI scan. These tests help to visualize the intestines and determine the extent of irritation caused by radiation therapy.
Management and Treatment
Complications
Potential complications of radiation enteritis may include anemia, diarrhea, and bowel obstruction. Anemia occurs due to chronic radiation enteritis, which may cause blood loss from the inflamed intestines. Severe or persistent diarrhea can lead to dehydration, electrolyte imbalances, and loss of fluids. In some cases, bowel obstruction may develop due to inflammation and scar tissue formation in the intestines.
Treatment
The treatments for radiation enteritis focus on relieving symptoms until the inflammation heals. In severe cases, tube feeding or surgery to remove sections of the intestine may be necessary. Treatment options may include:
- Medications: Doctors may prescribe medications to manage symptoms, such as anti-diarrheal drugs, pain relievers, and antibiotics if there's an infection.
- Lifestyle changes: Patients may be advised to follow a low-residue or low-fiber diet, avoiding foods that can exacerbate symptoms like spicy, fatty, or fried foods. They may also be encouraged to drink plenty of fluids to stay hydrated.
- Supportive care: In some cases, intravenous fluids or electrolyte replacement may be necessary to manage dehydration and maintain nutrition.
- Nutritional support: Tube feeding may be considered in cases where the intestine is severely affected, and oral intake is not possible. It is essential to note that the duration and severity of radiation enteritis can vary among individuals. In most cases, symptoms resolve within several weeks after radiation therapy ends. However, for some, it may last longer or recur months or years after treatment.