Radiation enteritis

Significant radiation exposure of the gastrointestinal tract produces early and late consequences. Therapeutic interventions are largely anecdotal, but there appear to be multiple mechanisms. The mechanism of injury and predisposing factors have been partially worked out in animal and cellular models. Clinical manifestations of chronic radiation enteritis vary and can be vague and difficult to characterize. Surgical intervention is required in 30% of patients with chronic radiation injury. A structured approach to assessing patients with GI symptoms after radiotherapy is useful as the therapeutic modality aimed at alleviating a specific symptom will clearly depend on the underlying pathology. Important information to gather at the time of presentation includes the history of the primary neoplasm, surgery performed, as well as an understanding of the duration and location of radiotherapy treatment, dosing regimen, target fields, and complications during treatment. Surgery may alleviate symptoms but is of greater risk than procedures on normal tissues.