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[Chronic radiation enteropathy. A retrospective study]

N Kryger-Baggesen1, B Moldow, G Rasmussen

  • 1Onkologisk afdeling ONK, Rigshospitalet, København.

Ugeskrift for Laeger
|December 20, 1993
PubMed
Summary
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Severe chronic radiation enteropathy, a complication of cancer treatment, frequently causes diarrhea and malabsorption. This study highlights significant bile acid and vitamin B12 malabsorption in patients, even without intestinal resection.

Area of Science:

  • Gastroenterology
  • Oncology
  • Radiation Medicine

Background:

  • Radiation enteropathy is a serious complication of pelvic radiation therapy for gynecological and urogenital cancers.
  • It can lead to chronic diarrhea, abdominal pain, weight loss, and malabsorption, significantly impacting patient quality of life.

Purpose of the Study:

  • To investigate the clinical presentation and malabsorption patterns in patients with severe chronic radiation enteropathy.
  • To correlate radiological findings with functional abnormalities in the small intestine.

Main Methods:

  • Retrospective analysis of 50 patients with severe chronic radiation enteropathy treated between 1968-1989.
  • Assessment of malabsorption using tests such as stool mass, fecal fat excretion, Schilling test, lactose absorption, and bile acid breath test.

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  • Correlation of clinical symptoms, surgical history, and malabsorption test results.

    • Main Results:

    • Diarrhea (74%), abdominal pain (62%), and weight loss (52%) were common initial symptoms.
    • Malabsorption was prevalent, with decreased vitamin B12 absorption (75%) and bile acid malabsorption (over 50%) noted in most patients.
    • Steatorrhea was observed in two-thirds of patients, and abnormal bile acid deconjugation was universal.

    Conclusions:

    • Severe chronic radiation enteropathy is characterized by significant malabsorption, particularly of bile acids and vitamin B12, irrespective of intestinal resection.
    • The findings underscore the need for comprehensive malabsorption assessment and management in these patients.
    • No correlation was found between radiological and functional small intestine abnormalities.