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Radiation Enteritis
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Radiation enteritis is also called radiation enteropathy and involves having damage to the delicate lining of the intestines, including the small and large intestines, due to radiation therapy in the management of cancer. Radiation enteritis is called by radiation, which uses high powered x-rays, radioactive seeds and particles which kill cancer cells. While cancer cells are usually killed somewhat easily, so are the normal cells of the body, including the intestinal cells. Persons at risk for radiation enteritis are those who receive radiation therapy to the abdomen, pelvis or cervix due to cancer of the cervix, uterus, colon, rectum, pancreas or prostate.
The symptoms of radiation enteritis include changes in the bowel movements. This can involve having mucus in the stools or diarrhea, blood from the rectum, watery stools, frequent bowel movements or rectal pain during bowel movements. Related symptoms include nausea, vomiting, a loss of appetite and stomach pain or cramping in the abdomen. The symptoms can be acute and can last only two to three weeks after the radiation treatments are over with. There is also the possibility of long term or chronic radiation enteritis, which leads to greasy or fatty stools, bloody diarrhea and weight loss.
Those at risk for radiation enteritis are those who have had focused beam radiation or who have had radiation beads placed in their abdomen for the treatment of abdominal or pelvic cancer.
The doctor can do some tests to affirm the diagnosis of radiation enteritis. These include having a barium enema, which uses X-rays and a dye infused into to the colonic lumen, a sigmoidoscopy or colonoscopy, or an upper GI endoscopy. The test used depends on what part of the colon or intestines is most likely involved in the enteritis.
Possible complications of radiation enteritis include having anemia and excessive rectal bleeding, dehydration from diarrhea and blood loss, malabsorption of food eaten, malnutrition and loss of weight due to a lack of absorption of food.
The treatment of radiation enteritis involves beginning a low fiber diet on the first day that the radiation treatment is started. The following foods should be avoided: tobacco, alcohol, milk products, soda with caffeine, chocolate, coffee and tea. You should not eat foods with whole bran, dried or fresh foots, fatty foods or greasy foods, nuts, seeds, popcorn, pretzels, potato chips, raw fruits and vegetables, rich pastries, fruit juices, especially citrus juices, or spicy food.
Foods you can eat with radiation enteritis include grape or apple juice, applesauce, bananas, eggs, yogurt, fish (all types), broiled or roasted meat or poultry, cooked fruits and vegetables and potatoes that have been mashed, boiled or baked, processed cheese, smooth peanut butter, noodles of all types and white bread.
Foods are best eaten at room temperature and you should eat food in small meals that are closer together than regular meals.
Medications that can be prescribed by the doctor for radiation enteritis include medications to control diarrhea such as loperamide, medications to control pain, steroid-containing foam injected into the colon, and enzymes that make the pancreas work better.
You should drink up to 12 full glasses of water every day in order to combat diarrhea and dehydration. IV fluids are not out of the question, especially if there is nausea and vomiting. The radiation can be temporarily reduced or stopped altogether in order to keep the symptoms at bay. There are no curative treatments for chronic radiation enteritis.
The prognosis of radiation enteritis is relatively good. Most people get completely better with no specific treatment after 2 to 3 weeks. Permanent damage to the lining of the intestinal tract is possible with chronic radiation enteritis the result.
There are ways to prevent radiation enteritis. Doctors can adjust the dose of radiation so that less radiation is given at a time but radiation is given over a longer period of time. If you have a full bladder during treatments, the degree of radiation enteritis is less. If the doctor places clips near the area needing radiation, the radiation is more focused so that the entire abdomen doesn't have to be involved in the radiation.