Radiation proctitis

What is radiation proctitis?

Proctitis is inflammation of the lining of the rectum and has a variety of causes. When this kind of inflammation occurs because of exposure to ionizing radiation, the condition is called radiation proctitis.

What causes radiation proctitis?

Radiation proctitis is a complication of radiation therapy. Those who have had radiation directed at their rectum or at areas around their rectum have increased risk of developing radiation proctitis. This includes areas such as the colon, prostate, cervix, or ovaries. 

Other causes of proctitis

In addition to radiation a variety of other conditions can cause proctitis.

• Inflammatory bowel disease (IBD)
• Infection
• Sexually transmitted disease (STD)

All causes of proctitis result in similar symptoms.

Symptoms

Radiation proctitis may begin during radiation treatment or not until years afterwards. It can be acute or last for months. If you are experiencing symptoms of proctitis, you should visit your doctor. Possible symptoms include:

• A continuous or frequent feeling that you need to have a bowel movement
• Mucus discharge from the rectum
• Rectal bleeding
• Rectal pain and/or pain with bowel movements
• Diarrhea
• A feeling of fullness in your rectum
• Pain on the left side of your abdomen
• Abdominal cramps

Symptoms of radiation proctitis are similar to symptoms of many other rectal conditions.

Diagnosis

If during a period of time you underwent radiation therapy, your doctor may suspect your symptoms are due to radiation proctitis.

Tests your doctor may perform to rule out other conditions could be:

Scope exam

A small flexible tube with a camera can be inserted into many areas of your gastrointestinal tract. Your doctor will most likely perform a sigmoidoscopy to examine the end of the colon and rectum. A biopsy can also be done during this exam—where a tissue sample is taken for testing.

Stool test

From a stool sample, doctors can determine if your symptoms may be due to infection.

Imaging exams

An abdominal ultrasound or CT scan may rule out disorders such as inflammatory bowel disease and allow doctors to see abnormalities.

Treatment

Mild cases of proctitis may heal on their own and not require treatment. Treatment for proctitis depends on its cause. If your doctor determines your proctitis is due to radiation, they may recommend medications that control inflammation, reduce bleeding, and soften stools. These medications can be given in pill, suppository, or enema form. It is important to talk with your doctor about the types of medications you’re most comfortable with. Surgery may be a recommended treatment option to remove tissue destroyed by inflammation. A technique called ablation can remove abnormal tissue and help improve symptoms.

Lifestyle changes

Depending on your symptoms, your doctor may recommend changing your diet. Eating foods that are high in fiber can soften stools naturally and improve some symptoms. Avoiding caffeine, fructose, and sugar alcohols (found in many sugar free foods) can improve diarrhea.

Research is currently being conducted to learn more about how to prevent and treat radiation proctitis.