Chronic radiation proctitis.
BACKGROUND
Increasing use of radiation therapy in pelvic malignancy has led to an increase in the incidence of chronic radiation proctitis. The commonest presenting complaint is rectal bleeding.


METHODS
A comprehensive MEDLINE search was undertaken for all articles relating to radiation proctitis.


RESULTS
The natural history of the disease is poorly documented but improvement is likely in milder forms, with persistence of symptoms in more severe forms. The pathological manifestations of the disease are summarized with particular comparison to acute radiation proctitis. The common clinical presentations and the principles of assessing patients with radiation-induced proctitis will be reviewed. The present article also reviews current treatment options, with particular reference to newer endoscopic therapies and surgical principles of management.


CONCLUSIONS
The initial therapy for problematic rectal bleeding related to radiation-induced proctitis shoud be endoscopic therapy with argon plasma coagulation or topical formalin therapy. Surgery is reserved as a last resort for resistant rectal bleeding and for complicated radiation-induced strictures and fistulas.
Tagkalidis
P P
PP
Department of Gastroenterology, Royal Melbourne Hospital, Victoria, Australia.
Tjandra
J J
JJ
D000208:Acute Disease; D000287:Administration, Topical; D002908:Chronic Disease; D018450:Disease Progression; D005557:Formaldehyde / Q000627:therapeutic use; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D017075:Laser Coagulation / Q000379:methods; D053685:Laser Therapy / Q000379:methods; D011349:Proctitis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*; D011351:Proctoscopy / Q000379:methods; D011878:Radiotherapy / Q000009:adverse effects*; D012002:Rectal Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*; D012597:Sclerosing Solutions / Q000627:therapeutic use; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
D012597:Sclerosing Solutions; D005557:Formaldehyde