What Is Radiation Proctitis?

Mary McMahon

Radiation proctitis is inflammation inside the lining of the rectum caused by exposure to radiation. It is usually associated with the use of radiation therapy for pelvic cancers like ovarian and prostate tumors. This is a known complication of cancer treatment that care providers consider when making treatment recommendations and administering radiation. Some controls can be used to limit incidental exposure and keep the patient safer from side effects.

Radiotherapy, such as with a linear accelerator, can result in radiation proctitis.
Radiotherapy, such as with a linear accelerator, can result in radiation proctitis.

Patients with radiation proctitis may notice pain during defecation, an overwhelming urge to defecate, and bloody, loose stool. Some experience incontinence and develop deposits of mucus as a result of the inflammation. Pelvic pain and tenderness can also occur. In a physical examination, care providers may be able to spot signs of inflammation, and they can also insert a camera to view the rectum and base of the colon. This can provide useful diagnostic information.

Patients with radiation proctitis may experience an overwhelming urge to defecate.
Patients with radiation proctitis may experience an overwhelming urge to defecate.

Acute cases of radiation proctitis occur rapidly after exposure to high doses of radiation. Advances in radiation technology allow care providers to carefully target patients, but high doses may be unavoidable for certain cancers, and this could be an inevitable risk. In chronic cases, exposure to lower doses over time results in proctitis approximately six months to a year later. Whether acute or chronic, the condition occurs when radiation-damaged cells slough off and are replaced with new ones in an acceleration of the normal process of epithelial cell replacement in the colon and rectum.

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Medications can be used to treat many cases of radiation proctitis. These can include antiinflammatory drugs as well as antibiotics to suppress infection. Some patients need pain management medication and may be advised to make some dietary adjustments like avoiding spicy food, which could increase the irritation. Surgery may be required in some cases to remove badly damaged tissue. It may be possible to use laser therapy in tissue ablation for a less invasive approach.

Pelvic radiation causes radiation proctitis in many cases. Sometimes patients experience only mild inflammation which can be controlled, although it may be unpleasant. It is important to discuss the risks and benefits of radiation therapy, and to talk about treatment plans ahead of time, so patients know what to expect and how to deal with complications when they arise. Patients expecting radiation proctitis as a known and common side effect of cancer treatment are better prepared for catching the signs early and getting appropriate treatment as soon as possible.

Radiation proctitis involves inflammation of the inner lining of the rectum.
Radiation proctitis involves inflammation of the inner lining of the rectum.

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