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Small bowel function after surgery for chronic radiation enteritis.

J Miholic1, H Vogelsang, O Schlappack

  • 1II. Chirurgische Klinik, Universität Wien, Osterreich.

Digestion
|January 1, 1989
PubMed
Summary
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Patients with ileal resection, especially due to radiation injury, show significantly reduced 75Se-homotaurocholic acid (SeHCAT) retention, indicating malabsorption. Radiation damage impairs motility, contributing to chronic diarrhea and malabsorption after surgery.

Area of Science:

  • Gastroenterology
  • Nuclear Medicine
  • Surgical Oncology

Background:

  • Ileal resection is a common treatment for radiation injury and other conditions.
  • Post-resection complications include malabsorption and chronic diarrhea.
  • Assessing the impact of radiation injury on small bowel function is crucial.

Purpose of the Study:

  • To evaluate 75Se-homotaurocholic acid (SeHCAT) retention in patients after ileal resection for radiation injury versus other causes.
  • To investigate the relationship between the extent of resection, radiation injury, and malabsorption.
  • To assess the role of impaired motility in post-irradiation diarrhea.

Main Methods:

  • SeHCAT retention was measured at 72 and 168 hours in three groups of patients.
  • Groups included those with ileal resection for radiation injury, chronic postirradiation diarrhea, and resection for other indications.

Related Experiment Videos

  • Hydrogen breath tests (lactulose and xylose) were used to assess orocecal transit time and xylose absorption.

    • Main Results:

    • All patients exhibited low SeHCAT retention (<50% at 72h, <20% at 168h).
    • Resected small bowel length inversely correlated with SeHCAT retention at 72h in groups I and III.
    • Shortened orocecal transit time was observed in the radiation injury group; xylose absorption was reduced in patients with positive xylose-H2 breath tests.

    Conclusions:

    • Radiation injury significantly contributes to malabsorption and diarrhea following ileal resection.
    • Chronic radiation damage appears to primarily affect intestinal motility.
    • SeHCAT retention is a valuable marker for assessing bile acid malabsorption in these patients.