Malabsorption following radiation therapy

Gastrointestinal injury is known to occur following radiation therapy of tumors in the abdominopelvic compartment. Chronic radiation changes may be associated with diarrhea and malabsorption. A patient with transitional cell carcinoma of the bladder developed diarrhea following radiotherapy and was treated symptomatically for nine years with the assumption that the diarrhea was secondary to radiation enteritis. Further evaluation including endoscopic cholangiopancreatography, revealed pancreatic insufficiency with steatorrhea as the probable cause of the patient's diarrhea. Although temporally related to radiation therapy, the etiology of his pancreatic insufficiency remains speculative. All patients developing diarrhea and/or malabsorption following radiotherapy should be evaluated thoroughly for treatable causes.