A retrospective study of the effects of pelvic irradiation for carcinoma of the cervix on gastrointestinal function.
OBJECTIVE
To evaluate the prevalence of disordered gastrointestinal function following therapeutic irradiation.


METHODS
Gastrointestinal function was evaluated in 30 randomly selected patients who had received pelvic irradiation for treatment of carcinoma of the cervix between 1 and 6 years previously. Each patient underwent evaluations of (a) gastrointestinal symptoms (b) absorption of bile acid, vitamin B12, lactose and fat (c) gastrointestinal transit: gastric emptying, small intestinal transit and whole gut transit and (d) intestinal permeability. Results were compared with those obtained in 18 normal volunteers.


RESULTS
Stool frequency was above the control range in five patients and had increased (p < 0.001) since radiotherapy treatment. Bile acid (p < 0.001) vitamin B12 (p < 0.01) and lactose (p < 0.01) absorption were less in the patients when compared with the control subjects. Bile acid absorption was below the control range in 14 of the 30 patients. Dietary calcium intake was lower (p < 0.05) in those patients with lactose malabsorption. Gastric emptying (p < 0.01) and small intestinal transit (p < 0.01) were more rapid in the patients. Both small intestinal (r = -0.39, p < 0.05) and whole gut (r = -0.45) transit were inversely related to stool frequency. Either bowel frequency, bile acid absorption, vitamin B12 absorption was outside the control range in 19 of the 30 patients.


CONCLUSIONS
Abnormal gastrointestinal function is essentially an inevitable long-term sequel of pelvic irradiation.
Department of Radiation Oncology, Royal Adelaide Hospital, Australia.
E
E
Yeoh
M
M
Horowitz
A
A
Russo
T
T
Muecke
A
A
Ahmad
T
T
Robb
B
B
Chatterton
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001647:Bile Acids and Salts / Q000378:metabolism; D004041:Dietary Fats / Q000378:metabolism; D004064:Digestive System / Q000528:radiation effects*; D004068:Digestive System Physiological Phenomena; D005260:Female; D005746:Gastric Emptying / Q000502:physiology / Q000528:radiation effects; D005767:Gastrointestinal Diseases / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D005772:Gastrointestinal Transit / Q000502:physiology / Q000528:radiation effects; D006801:Humans; D007408:Intestinal Absorption / Q000502:physiology / Q000528:radiation effects; D007785:Lactose / Q000378:metabolism; D008875:Middle Aged; D010388:Pelvis / Q000528:radiation effects; D015995:Prevalence; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000532:radiotherapy*; D014805:Vitamin B 12 / Q000378:metabolism
D001647:Bile Acids and Salts; D004041:Dietary Fats; D007785:Lactose; D014805:Vitamin B 12