Radiation proctopathy

Abstract

Acute radiation proctopathy (ARP) and chronic radiation proctopathy (CRP) are common complications of pelvic radiation therapy. ARP is by definition a self-limited process and is characterized by abdominal symptoms and diarrhea that occur during radiation therapy. Treatment is directed at reduction of symptoms with stool bulking agents and anti-diarrheal medications. CRP occurs at least 3 months after completion of radiation therapy and is associated with significant morbidity. The most common symptom of CRP is rectal bleeding from rupture of mucosal telangiectasias and local mucosal ischemia. Functional symptoms occur from loss of rectal compliance and anal sphincter injury. These symptoms include urgency, tenesmus, increased stool frequency and fecal incontinence. These problems have received less attention in the medical literature. Profound blood loss and fistulization are severe conseq uences of CRP. Argon plasma coagulation is recommended as optimal treatment for bleeding from telangiectasias. Retinol (retinyl) palmitate has demonstrated efficacy for functional symptoms.