Guide To Managing Radiation Enteritis
Radiation enteritis is a condition that occurs in individuals undergoing radiation therapy where the lining of the intestines becomes damaged and inflamed. This condition affects patients having radiation therapy aimed at the pelvis, abdomen, or rectum. Radiation enteritis occurs because the high-energy particles, x-rays, or radioactive seeds used in radiation therapy destroy not only the cancerous cells but the healthy cells as well. Individuals affected by this condition commonly experience nausea, vomiting, diarrhea, abdominal cramps, loss of appetite, and bloody stools. For most individuals affected by this condition, symptoms will improve within a couple of months after the end of their radiation regimen. However, a few patients will experience chronic and long-term symptoms.
Treatment of radiation enteritis focuses on the management of symptoms and the prevention of further complications.
Medication To Treat Diarrhea And Pain
Most radiation enteritis patients will experience some degree of diarrhea and frequent abdominal pain. Diarrhea describes watery and loose stools. In a healthy individual, food moves from the stomach into the small intestine where all the nutrients are absorbed out of it. Food then moves into the large intestine where most of the fluid is absorbed. However, in cases of diarrhea, the stool moves too quickly through the large intestine for it to absorb a reasonable amount of fluid. Sometimes, diarrhea is caused by a functional failure of the large intestine to absorb fluid and not due to rapid movement. In individuals who have radiation enteritis, the lining of the large intestine may be too damaged or too inflamed to absorb fluid from the food adequately. The inflammation of the large intestine also causes severe abdominal cramping. Prescription strength medications are used to treat diarrhea by slowing the food down or through the use of other chemical mechanisms. Prescription strength pain medicine may also be prescribed to block the pain caused by excessive cramping.
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Feeding Tube
There are numerous reasons why a feeding tube may need to be utilized during treatment for radiation enteritis. The common symptoms of nausea and vomiting that present in most radiation enteritis patients can cause them to stop eating regularly. Patients who are also affected by cancer will rapidly lose weight and become deficient in many nutrients when they stop eating regularly. Other individuals may be so affected by the pain of food moving through the bowel that they quit consuming food regularly. It is also possible for the intestines to become so damaged or inflamed that they simply cannot perform their function of absorbing nutrients despite the regular consumption of food. When diet changes and medication are ineffective at treating symptoms causing an individual with radiation enteritis to become malnourished, a feeding tube may be needed. Often, the temporary use of a feeding tube will put less strain on the patient's intestines and allow for easier healing. In addition, bacterial overgrowth may become an issue with damaged intestines. When this cannot be mediated with diet or medication, a feeding tube may be recommended to maintain the correct bacterial balance in the gut.
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Changes In Diet
All individuals who develop radiation enteritis will usually have to make some changes to their diet. The first diet changes typically made include avoiding things that worsen symptoms. Dairy, alcohol, tobacco, caffeine, whole bran, dried fruits, high-fat foods, nuts, seeds, popcorn, raw vegetables, baked goods, potato chips, pretzels, and strong spices can all exacerbate symptoms of radiation enteritis. Foods generally better for individuals affected by radiation enteritis include poultry, fish, broiled or roasted meat, mildly cooked vegetables, baked potatoes, smooth peanut butter, apple juice, grape juice, eggs, applesauce, and bananas. Aside from changes in what a patient eats, there are also other changes associated with diet that may help with symptoms. These changes include eating small meals on a more frequent basis, eating food at room temperature, and drinking at least twelve glasses of fluids every day. Generally, individuals with radiation enteritis can avoid problems by consuming a low-fiber diet.
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Course Of Antibiotics
Treatment for radiation enteritis patients may include one or more courses of antibiotics to help control bacteria overgrowth in their small intestine. Healthy individuals will not usually experience a bacterial overgrowth of the bacteria that naturally occurs in the gut because a thick layer of protective mucus acts as a barrier in the digestive tract. Radiation therapy causes damage to this protective mucosal barrier in the intestinal wall, leaving it vulnerable to bacterial invasion. This compromise in the intestinal wall allows for naturally occurring gut bacteria to reach deeper tissues. Once this bacteria reaches tissues underneath the layer of mucus, they begin to grow out of control. This overgrowth results in bloating, stomach pain, constipation, nausea, weight loss, malnutrition, and diarrhea. Prescription antibiotics are generally used to treat this bacterial overgrowth. Antibiotics are potent medications that target and kill off the colony of problematic bacteria. Nutritional supplements are also often needed with the antibiotics to replenish any nutrients lost as a result of the bacterial overgrowth.
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Surgical Intervention
Some individuals with severe cases of radiation enteritis may require surgical intervention to restore reasonable function to their digestive tract. Segments of the small and large intestine may become damaged from radiation to the point where food is no longer able to pass through them physically. If left untreated, this often leads to a life-threatening bowel obstruction. Should bowel obstructions become a problem, surgical intervention will be required.
Other radiation enteritis patients may not have frequent bowel obstructions, but they may experience different symptoms to an excessive or severe degree. Complications such as malnutrition, pain, dehydration, and diarrhea may become incredibly debilitating to a patient. When other treatment methods are ineffective to treat these complications, surgical intervention may be recommended. Surgery to treat radiation enteritis involves creating a bypass so food can move around the diseased parts of the intestine. Another surgical approach to radiation enteritis is to remove the diseased section of the bowel entirely, and then connect the remaining bowel segments together.