Radiation Enteritis

What is radiation enteritis?

Radiation enteritis is a condition that occurs when radiation therapy causes damage to your intestines. Radiation therapy uses radioactive substances to destroy abnormal cells. It’s a common treatment for cancer and certain blood disorders.

Other terms that describe this condition include:

• Pelvic radiation disease.
• Radiation colitis.
• Radiation enteropathy.
• Radiation-induced bowel disease.
• Radiation mucositis.

What are the types of radiation enteritis?

The condition can be acute or chronic:

• Acute radiation enteritis occurs while you’re undergoing radiation therapy. Symptoms typically go away in a few weeks.
• Chronic radiation enteritis develops months to years after completing treatment. Symptoms stay with you for a long time and can lead to complications.

How common is radiation enteritis?

Radiation enteritis is far less common than it used to be. When older techniques of radiation therapy were delivered to your abdomen or pelvis, up to half of the people undergoing treatment could develop radiation enteritis. With modern techniques of radiation therapy, your risk of chronic radiation enteritis is much lower.

Some people face a higher risk due to:

• Conditions that decrease blood flow to their intestines, such as diabetes and high blood pressure.
• Existing tissue irritation due to conditions like pelvic inflammatory disease.
• Other treatments that destroy cells, such as chemotherapy.
• Poor nutrition.
• Smoking and other forms of tobacco use.
• Tissue damage from prior abdominal surgeries.

How does radiation therapy affect the intestines?

Treatment typically requires regular exposure to radioactive substances for several weeks. When radiation reaches healthy cells, it causes inflammation and tissue damage. Cells in the lining of your intestines are more sensitive to the effects of radiation.

Repeated exposures can destroy cells responsible for blocking infections and regulating fluid levels. The more doses you receive and the larger the area of bowel treated, the more likely you’re to develop radiation enteritis.

What are the symptoms of radiation enteritis?

Symptoms may include:

• Abdominal pain and cramping.
• Bloated stomach.
• Diarrhea.
• Loss of appetite.
• Nausea and vomiting.
• Pain when you poop.
• Rectal bleeding or pain.
• Unintended weight loss.
• Urgent need to poop.

What are the complications of radiation enteritis?

Ongoing irritation and inflammation in your intestines can lead to:

• Dehydration.
• Electrolyte imbalances.
• Fistula, an abnormal connection between your intestines and a nearby organ.
• Intestinal perforation, tears in the lining of your intestines.
• Malabsorption, an inability to absorb nutrients from food.
• Small bowel obstruction.
• Stricture, narrowing of your intestines.
• Ulcers, including peptic ulcer disease.

How is radiation enteritis diagnosed?

Healthcare providers often make a diagnosis by asking you about your symptoms and your history of radiation exposure.

Additional testing may be necessary to rule out other conditions or assess severity. These include:

• Hydrogen breath test for bacterial overgrowth.
• Lower or upper endoscopy.
• X-ray.
• Other imaging tests, such as a CT scan or MRI if X-ray results don’t provide enough information.

How is radiation enteritis treated?

It might not be possible to repair chronic intestinal cell damage from radiation exposure. But medical management of radiation enteritis can help you stay comfortable and avoid complications.

Your care may include:

• Antibiotics if there are too many bacteria in your intestines.
• Antidiarrheals, medications that slow intestinal activity to relieve diarrhea.
• Corticosteroids to quiet inflammation in your intestines.
• Pain relievers.

How are radiation enteritis complications treated?

The options that are right for you depend on the type of complication. Strictures, fistulas and perforations often need surgery. You may need supplements or tube feeding if you aren’t getting enough nutrients.

What can be done to prevent radiation enteritis?

There are steps your care team can take to protect your intestines during radiation therapy. These include:

• Custom positioning devices to hold your body still during treatments.
• Modern treatments, like intensity-modulated radiation therapy (IMRT) that deliver radiation to precisely the right spot.
• Protective shields for your bowel or rectum.

What is the outlook for people with radiation enteritis?

People with acute radiation enteritis typically feel better within a few weeks. If you have chronic radiation enteritis, it can take several months.

What’s important to know about living with radiation enteritis?

The benefits of radiation for cancer treatment typically outweigh the risks of developing radiation enteritis. That’s why it’s usually essential to continue radiation therapy, even if it makes you sick.

If you have concerns about how radiation enteritis may affect your health, talk with your healthcare provider. They can discuss potential options, like changing the frequency or dose of radiation therapy or other treatments for radiation enteritis symptoms.

Is there anything else I can do to feel better during radiation therapy?

Paying careful attention to your diet and fluid intake can ease discomfort and promote healing.

Avoid consuming foods and beverages that are difficult to digest. These include:

• Alcohol.
• Carbonated beverages.
• Dairy products.
• Greasy, processed or fried foods.
• High-fiber foods, like raw vegetables.
• Spicy foods.

Eat high-nutrient foods that are easy on your stomach, such as:

• Baked or broiled lean meats, like chicken.
• Bananas and apples.
• Canned fruits and vegetables.
• Clear broth.
• Cooked vegetables, including carrots and potatoes.
• Dry toast.

A note from Cleveland Clinic

If you’re undergoing radiation therapy, there are steps healthcare providers can take to shield healthy tissue from radiation exposure. If you’re experiencing symptoms of radiation enteritis, talk to your healthcare provider. Treatments can relieve discomfort and lower the risk of complications.