title: [Nonsurgical treatment of chronic radiation-induced hemorrhagic proctitis].
abstract: The incidence of radiation-induced chronic hemorrhagic proctitis is less than 10 to 20%. The onset of this proctitis is delayed relative to the radiation therapy and generally develops from 6 to 24 months later. There are numerous predisposing factors, the most important of which is the radiation therapy dose: risk increases exponentially above 40-45 Gy. Its pathophysiology involves progressive obliterating endarteritis and transmural interstitial fibrosis, which induce chronic ischemia that is irreversible and progressive during the years after radiation therapy. Its diagnosis depends most often on the combination of clinical history and typical endoscopic appearance (congestive mucosa and/or telangiectases). Topical administrative of sucralfate or corticosteroids as well as argon plasma coagulation, with formalin treatment if necessary, provides relief for most patients.
authors: Service de proctologie médico-interventionnelle, Groupe hospitalier Diaconesses - Croix Saint-Simon, F-75012 Paris, France. proctologie@hopital-dcss.org
authors: Vincent
authors: V
authors: de Parades
authors: Pierre
authors: P
authors: Bauer
authors: Philippe
authors: P
authors: Marteau
authors: Laurent
authors: L
authors: Chauveinc
authors: Thierry
authors: T
authors: Bouillet
authors: Patrick
authors: P
authors: Atienza
mesh_terms: D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D002908:Chronic Disease; D003092:Colitis / Q000209:etiology / Q000628:therapy*; D005557:Formaldehyde / Q000627:therapeutic use; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D006801:Humans; D017075:Laser Coagulation; D011350:Proctocolitis / Q000209:etiology / Q000628:therapy; D011832:Radiation Injuries / Q000209:etiology / Q000628:therapy*; D011878:Radiotherapy / Q000009:adverse effects*; D011879:Radiotherapy Dosage; D012307:Risk Factors; D013392:Sucralfate / Q000627:therapeutic use; D013997:Time Factors
chemical_list: D000897:Anti-Ulcer Agents; D005557:Formaldehyde; D013392:Sucralfate