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Pharmacotherapy for chronic hemorrhagic radiation proctitis
Yunus A Gul1, Subhita Prasannan, Faisal M Jabar
1Department of Surgery, University Putra Malaysia, Serdang, Selangor 43400, Malaysia. yunus@medic.upm.edu.my
World Journal of Surgery
|September 26, 2002
Summary
Sucralfate enemas effectively treat chronic hemorrhagic radiation proctitis, offering symptomatic relief. This medical therapy is a recommended first-line option, reserving specialized treatments for treatment failures.
Area of Science:
- Gastroenterology
- Radiation Oncology
Background:
- Chronic hemorrhagic radiation proctitis is a common complication following pelvic radiotherapy.
- Endoscopic therapies like thermal therapy and formalin are increasingly used, but pharmacologic agents remain relevant, especially where specialized equipment is unavailable.
Purpose of the Study:
- To prospectively assess the effectiveness of medical therapy for chronic hemorrhagic radiation proctitis.
Main Methods:
- A prospective study of 14 women with chronic hemorrhagic radiation proctitis treated between July 1999 and June 2001.
- Patients received either continued hydrocortisone enemas or were started on sucralfate enemas.
- Treatment outcomes and recurrence rates were monitored.
Main Results:
- Sucralfate enema suspension provided symptomatic relief in all 11 patients treated with it.
- Eleven patients required blood transfusions due to anemia (hemoglobin < 8 g/dl).
- Two patients experienced recurrence after initial treatment but were successfully managed with topical formalin.
Conclusions:
- Sucralfate enema is an effective first-line treatment for chronic hemorrhagic radiation proctitis.
- Medical management should be considered, particularly in settings lacking specialized equipment.
- Specialized therapies can be reserved for cases refractory to sucralfate treatment.