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Bile acids in radiation-induced diarrhea.
F L Arlow1, A A Dekovich, R J Priest
1Division of Gastroenterology, Henry Ford Hospital, Detroit, Mich.
Southern Medical Journal
|October 1, 1987
Summary
Radiation therapy for pelvic cancers can cause diarrhea due to bile acid malabsorption. Treating this with cholestyramine improved symptoms and quality of life for patients with radiation-induced bowel disease.
Area of Science:
- Gastroenterology
- Oncology
- Radiation Medicine
Background:
- Radiation therapy for pelvic malignancies can lead to radiation-induced bowel disease, often presenting as debilitating diarrhea.
- The exact mechanism is unclear, but damage to the small bowel mucosa and subsequent bile acid malabsorption are suspected.
- Elevated bile acids in the intestines can stimulate water and electrolyte secretion, increasing bowel motility.
Purpose of the Study:
- To investigate the role of bile acids in radiation-induced diarrhea.
- To assess the efficacy of cholestyramine in managing this condition.
Main Methods:
- Direct measurement of individual and total bile acids in stool samples from 11 patients with radiation-induced diarrhea.
- Administration of cholestyramine to patients with elevated stool bile acids and diarrhea.
Main Results:
- Eight out of eleven patients exhibited elevated bile acid levels in their stool, ranging from two to six times the normal amount.
- Patients treated with cholestyramine experienced a prompt improvement in their condition.
- Treatment led to a reduction in stool frequency and an improved lifestyle for the patients.
Conclusions:
- Bile acid malabsorption is a significant factor in radiation-induced diarrhea.
- Cholestyramine is an effective treatment for radiation-induced diarrhea associated with elevated bile acids.
- Targeting bile acid malabsorption can alleviate symptoms and improve the quality of life for patients undergoing pelvic radiation therapy.