Radiation Proctitis

Early Symptoms

Chronic Symptoms (lasting more than three months)

• Rectal bleeding: Ranging from mild blood streaks to significant bleeding.
• Rectal fibrosis: Hardening or narrowing of the intestinal wall.
• Increased urgency and discharge: Due to reduced rectal elasticity.
• Severe cases May lead to ulcers, intestinal perforation, or peritonitis.

• Anemia: Chronic or significant rectal bleeding can cause iron-deficiency anemia, leading to fatigue, dizziness, or shortness of breath.
• Acute hemorrhage: Severe cases may require blood transfusion or urgent endoscopic hemostasis.

Structural Changes in the Intestine

• Loss of elasticity may result in rectal narrowing or impaired bowel function.
• Intestinal stricture: Fibrosis narrows the rectal lumen, affecting bowel movements and possibly requiring surgical intervention.
• Intestinal perforation: Severe inflammation and ulcers may cause bowel rupture, leading to peritonitis.

Infections

• Intestinal infection: Damaged rectal tissue makes it susceptible to bacterial invasion, causing persistent inflammation or abscesses.
• Peritonitis: Following bowel perforation, the infection can spread to the abdominal cavity, a medical emergency.

Functional Issues

• Fecal incontinence: Reduced bowel elasticity or damage to rectal muscles may impair bowel control.
• Urgency: Loss of normal rectal storage function may cause frequent and urgent bowel movements.
• Excessive discharge: Damaged rectal mucosa may increase mucus secretion.

Psychological Health Issues

• Anxiety and depression: Chronic symptoms can affect quality of life, leading to mental distress.
• Social challenges: Symptoms like frequent bowel movements, incontinence, or bleeding can hinder social activities.
   

Medication

Enema Therapy:

• Sucralfate enema: Forms a protective layer on the intestinal mucosa to promote healing.
• Non-steroidal anti-inflammatory drugs (e.g., mesalamine): To reduce inflammation.

Adjunctive Therapy:

• Hyperbaric oxygen therapy: Promotes tissue healing (available in select hospitals).

Endoscopic Treatment

• Argon plasma coagulation (APC): Uses thermal coagulation to stop bleeding.
• Radiofrequency ablation (RFA): Applies pressure and heat to achieve hemostasis quickly.

Surgical Treatment

• For severe fibrosis or intestinal strictures, stoma placement may be performed to relieve symptoms.

Diet and Lifestyle Management

• Avoid high-fiber, high-fat, and irritating foods.
• Increase protein intake to promote wound healing.
• Attend regular follow-ups to monitor hemoglobin levels and intestinal health.