Radiation Colitis

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Your doctor has determined that you have radiation colitis, an inflammation of the colon that occurs as a side effect of cancer radiation therapy to the abdomen or pelvis. The condition can arise from external radiation treatment delivered by a high energy X-ray machine or internal radiation therapy, which is delivered through small implants placed directly into or near the cancerous tumor.

About the Condition

The colon, or large intestine, is a tube lined with muscles that extracts moisture and nutrients from food, storing the waste matter until it is expelled from the body. It is typically 5–6 feet long in adults. The last segment of the colon is called the rectum.

Radiation colitis occurs when an increasing number of cells in the colon die as a result of radiation therapy. Often the doses of radiation that cause colon injury are very close to the doses needed to treat cancer in the abdomen or pelvis. The severity of the condition depends on the size of the radiation dose and other factors such as the frequency of treatment and tumor size.

Radiation colitis can be acute, coming on suddenly, or chronic, developing gradually and persisting. Most of the time, patients with acute radiation colitis develop symptoms within eight weeks of starting their treatment. With the chronic form of the condition, symptoms may not arise until months or years after radiation therapy is over.

Symptoms of radiation colitis may include abdominal cramps, diarrhea, nausea, vomiting, frequent urges to have a bowel movement, rectal bleeding, weight loss and fatty stools. Complications can develop, especially in chronic radiation colitis, such as:

•  Intestinal blockage
•  Infection/abscesses
•  Nutritional deficiencies
•  Heavy rectal bleeding
•  Bowel rupture
•  Cystitis (bladder inflammation)

Although the cause of radiation colitis is cancer radiation therapy, other risk factors can increase the risk of radiation injury to the colon such as surgical scar tissue, high blood pressure, diabetes, atherosclerosis (hardening of the arteries) and underlying inflammatory bowel disease.

Treatment Options

The treatment plan for radiation colitis often depends on the specific symptoms and severity of the condition. The following treatment possibilities are available:

Everyday Changes Although food is not a direct cause of radiation colitis, people with the condition can diminish symptoms by eating a low-fat and low-fiber diet, drinking plenty of fluids and avoiding certain foods, caffeine and dairy products. Iron or other nutritional supplements may be needed, as well. Patients are also encouraged to get plenty of rest.

Medication A variety of medications can be used to treat radiation colitis. They include drugs to control diarrhea, nausea and bleeding, pain relievers, and steroid foams that help relieve rectal inflammation and irritation.

Surgery In very rare cases of severe radiation colitis, an operation to bypass the large intestine (colon resection) or remove it entirely (colectomy) may be performed.

Other medications and procedures to treat and prevent radiation colitis are currently being studied.

What You Can Do

You can choose to take an active role in your health and well-being. Since nutrition has an impact on radiation colitis, you should start a low-fiber, low-fat diet the first day of radiation therapy and continue it for two to three weeks after treatment, when symptoms of the condition usually subside.

Other steps you can take to maximize your health and minimize symptoms include:

•  Eating smaller, more frequent meals with foods at room temperature
•  Drinking three quarts of liquids each day to prevent dehydration, which can include apple and grape juices and flat, non-caffeinated carbonated drinks
•  Limiting dairy products (except buttermilk, yogurt and processed cheese)
•  Avoiding whole-grain bread and cereal, raw vegetables, fresh and dried fruit and nuts, seeds and coconut
•  Adding nutmeg to your food to slow the digestion process
•  Avoiding smoking, alcohol, caffeinated beverages, chocolate and fatty, fried, refined and highly seasoned foods
•  Eating foods such as broiled or roasted fish, meat and poultry, eggs, macaroni and noodles, white bread and toast, smooth peanut butter, bananas, applesauce, baked, broiled or mashed potatoes and mild cooked vegetables such as asparagus tips, green beans, carrots, spinach and squash

Additional Resources

American College of Gastroenterology, 301.263.9000, http://www.acg.gi.org/
National Cancer Institute, 800.422.6237, http://www.cancer.gov/
Digestive Diseases Information Clearinghouse, 800.891.5389, http://www.digestive.niddk.nih.gov/

This patient resource sheet is provided to you as a service of CBLPath® and is intended for information purposes only. It may not fully describe all aspects of your diagnosis and is not meant to serve as medical advice or a substitute for professional medical care. Your physician can provide you with a thorough explanation of your diagnosis and appropriate treatment options, which may vary. Only you and your physician can determine your best treatment plan.

Updated 9.07