Radiation proctitis as a differential of lower GIT bleeding in Nigeria: A case series
Main Article Content
Keywords
Radiation, proctitis, bleeding, prostrate, cancer, colonoscopy
Abstract
Pelvic radiotherapy is an acceptable and promising treatment modality for various pelvic malignancies. However, it is associated with radiation-induced injury on surrounding structures with a preference for the rectum, which is characteristically fixed in the pelvic region. Acute radiation proctitis is usually self-limiting, but in its chronic form, it can be debilitating. Recent advances in radiation therapy have significantly reduced the prevalence of radiation proctitis (RP) in high-income countries, contrary to the findings in low and middle-income countries witnessing an increasing burden of radiation proctitis. This observation can be attributed to the increased availability of radiation therapies with limited use of novel technologies designed to reduce the detrimental effects of radiotherapy and improve the detection of RP owing to improvements in endoscopic services in developing countries. This is a highlight of the trends in the presentation of RP, management modalities in various tertiary centers in Nigeria, and the limitations in care occasioned by the non-availability of argon plasma coagulation (APC) as an effective treatment modality in most tertiary health facilities in Nigeria.
References
2. Dahiya DS, Pinnam BSM, Ishaya M, Chandan S, Gangwani MK, Singh S, et al. Early and late readmissions of radiation proctitis in the United States: Are we getting better? J Clin Med. 2024 Jan 1;13(2).
3. Grodsky MB, Sidani SM. Radiation proctopathy. Clin Colon Rectal Surg. 2015 Jun 27;28(2):103-11.
4. Mahmood S, Bollipo S, Steele S, Bristow RG, Choudhury A, Oakland K, et al. It’s all the RAVE: Time to give up on the “chronic radiation proctitis” misnomer. Gastroenterology [Internet]. 2021;160(3):635-8. Available from: https://doi.org/10.1053/j.gastro.2020.09.054
5. Weiner JP, Wong AT, Schwartz D, Martinez M, Aytaman A, Schreiber D. Endoscopic and non-endoscopic approaches for the management of radiation-induced rectal bleeding. World J Gastroenterol. 2016;22(31):6972-86.
6. Do NL, Nagle D, Poylin VY. Radiation proctitis: Current strategies in management. Gastroenterology Res Pract. 2011.
7. Vanneste BG, et al. Chronic radiation proctitis: tricks to prevent and treat. Int J Colorectal Dis. 2015;30(10):1293-303. doi:10.1007/s00384-015-2289-4
8. Chargari C, Deutsch E, Blanchard P, Gouy S, Martelli H, Guérin F, et al. Brachytherapy: An overview for clinicians. CA Cancer J Clin. 2019 Sep;69(5):386-401.
9. Kishan AU, Kupelian PA. Late rectal toxicity after low-dose-rate brachytherapy: Incidence, predictors, and management of side effects. Brachytherapy [Internet]. 2015;14(2):148-59. Available from: http://dx.doi.org/10.1016/j.brachy.2014.11.005
10. Leiper K, Morris AI. Treatment of radiation proctitis. Clin Oncol. 2007;19(9):724-9.
11. Karamanolis G. Endoscopic treatments for chronic radiation proctitis. World J Gastrointest Endosc. 2013;5(7):308.
12. Ribault A, Benadjaoud MA, Squiban C, Arnaud L, Judicone C, Leroyer AS, et al. Circulating microvesicles correlate with radiation proctitis complication after radiotherapy. Sci Rep [Internet]. 2023;13(1):1-12. Available from: https://doi.org/10.1038/s41598-022-21726-y
13. Bansal N, Soni A, Kaur P, Chauhan AK, Kaushal V. Exploring the management of radiation proctitis in current clinical practice. J Clin Diagn Res. 2016;10(6):XE01-6.
14. Ali F, Hu KY. Evaluation and management of chronic radiation proctitis. Dis Colon Rectum. 2020;63(3):285-7.
15. Zhang H, Cai W, Xu D, Liu J, Zhao Q, Shao SE. Effects of mesenchymal stem cells on Treg cells in rats with colitis. Clin Exp Immunol. 2023;214(3):296-303.
16. Sahebnasagh A, Ghasemi A, Akbari J, Alipour A, Lashkardoost H, Ala S, et al. Prevention of acute radiation-induced proctitis by Aloe vera: A prospective randomized, double-blind, placebo-controlled clinical trial in pelvic cancer patients. BMC Complement Med Ther. 2020;20(1):1-9.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
This is an open-access journal and articles are distributed under the terms of the Creative Commons Attribution Non-Commercial Share-Alike License 4.0. This licence allows users to download and share, remix, tweak and build upon the article for non-commercial purposes, so long as the original authorship is acknowledged and the new creations are licensed under identical terms.