Radiation enteritis symptoms?

summary

Radiation enteritis is an intestinal complication caused by radiotherapy for pelvic, abdominal and retroperitoneal malignant tumors. It can affect small intestine, colon and rectum respectively, so it is also called radioactive rectum, colon and enteritis. Radiation sickness can be divided into acute and chronic according to the size of radiation dose, the length of time and the severity of the disease. According to the different location of the radiation source, it can be divided into external radiation sickness and internal radiation sickness. In the early stage, the renewal of intestinal mucosal cells was inhibited, and then the arteriole wall swelled and occluded, causing intestinal wall ischemia and mucosal erosion. In late stage, intestinal wall fibrosis, intestinal cavity stenosis or perforation, abdominal abscess, fistula and intestinal adhesion were caused. Radiation enteritis symptoms? Let's talk about it.

Radiation enteritis symptoms?

1. Early symptoms due to the nervous system response to radiation, early gastrointestinal symptoms can appear. It usually occurs within 1-2 weeks after radiotherapy. Nausea, vomiting, diarrhea, discharge of mucus or bloody stool. The rectal involvement was accompanied by severe back pain. Persistent hematochezia can cause iron deficiency anemia. Constipation is rare. I have low fever occasionally. Spasmodic abdominal pain indicates involvement of the small intestine. Sigmoidoscopic examination shows mucosal edema and hyperemia. In severe cases, there may be erosion or ulcer.

2. Late symptoms. Persistent symptoms in the acute stage or significant symptoms 6 months to several years after the end of radiotherapy indicate that the disease will continue and eventually develop into fibrosis or stenosis. The symptoms in this period can occur as early as half a year after radiotherapy, and as late as 10 years or even 30 years later, which are mostly related to intestinal wall vasculitis and subsequent lesions（ 1) Colitis and proctitis often appear 6-18 months after irradiation. Symptoms include diarrhea, bloody stool, mucus stool, diarrhea, constipation or abdominal pain. Serious lesions and adjacent organs form fistula, such as rectovaginal fistula, feces from the vagina; Recto intestinal fistula can appear chyme mixed in feces, also can cause peritonitis due to intestinal perforation, abdominal or pelvic abscess. Intestinal obstruction may occur due to intestinal stricture and loop entanglement（ 2) Severe abdominal pain, nausea and vomiting, abdominal distension and blood like diarrhea occurred when the small intestine was seriously damaged by radiation. But in the late stage, dyspepsia was the main manifestation, accompanied by intermittent abdominal pain, fat diarrhea, emaciation, fatigue, anemia and so on.

3. X-ray examination and intestinal barium examination are helpful to determine the extent and nature of lesions. But the signs were not specific. Barium enema showed small serrated edge of colon mucosa, irregular folds, stiffness or spasm of intestinal wall. Sometimes, intestinal stenosis, ulcer and fistula can be seen. The X-ray signs of a small number of mucosa on the edge of ulcer may be uplifted, which is similar to cancer. The differential point is that the lesion segment and the normal intestinal segment gradually move without a clear dividing line, which is different from cancer. The sigmoid colon is low and folded into an angle. Barium examination of the small intestine showed that the lesions were mainly at the end of the ileum. During barium filling, the lumen was irregular and narrow, and was pulled into an angle due to adhesion, forming prickle like shadow, thickening of intestinal wall and widening of intestinal curvature spacing. Nodular filling defect of intestinal cavity was also seen, which was similar to inflammatory bowel disease. The normal feathery mucosal striations of small intestine disappeared during emptying.

matters needing attention

Avoid eating food with more cellulose or stimulating intestinal wall, and eat food with less residue, low fat and less gas production. Such as carrot, spinach and so on, not only moisten the intestines, but also supplement vitamins. Also should pay attention to keep anus and perineum clean, wear loose underwear. If the symptoms are serious, radiotherapy can be suspended, and a large dose of vitamin and infusion can be used to supplement various intravenous nutrition, adrenocortical hormone and antibiotics can be used to reduce local inflammatory reaction and promote recovery.