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Chronic Radiation Enteritis
⚠️ Chronic Radiation Enteritis is a delayed complication of radiotherapy that can damage both the small and large bowel, sometimes appearing years after exposure.
📖 About
- Can affect small and large bowel.
- Often develops months to years after radiation therapy.
🧬 Aetiology
- Proliferative endarteritis & vasculitis: → leads to bowel ischaemia and fibrosis.
- Risk factors: Diabetes, hypertension, and smoking worsen vascular injury.
☢️ Cause
- Radiation therapy for cancer (pelvic, abdominal, prostate, cervical, rectal malignancies).
- Exposure via external beam irradiation or radioactive implants.
📊 Classification
- Acute: Appears during or within 2 months of treatment.
- Subacute: 2–12 months after therapy.
- Chronic: >12 months after radiation exposure.
🩺 Clinical Presentation
- General: Nausea, vomiting, chronic abdominal pain, weight loss.
- Bowel dysfunction: Diarrhoea, rectal bleeding, fecal incontinence.
⚠️ Complications
- Structural: Strictures, ulceration, fibrosis.
- Fistulas: Colovesical or colovaginal fistula formation.
🔍 Investigations
- Blood tests: FBC, U&E, LFTs, ESR, CRP.
- Imaging: CT / MRI to detect bowel wall thickening, obstruction, strictures, and fistulas.
💊 Management
- Symptom control: Nutritional optimisation, anti-diarrhoeals, analgesia.
- Surgical: Resection of strictures or closure of fistulas (challenging due to adhesions/scarring).
📚 References
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