Radiation-induced intestinal lesions - Treatment

Even with minimal signs of damage to the small intestine, broad-spectrum antibiotics are recommended; aspirin, which suppresses prostaglandin activity; agents that neutralize pancreatic secretion, a full diet during the entire period of radiation therapy. In the acute period, reducing the radiation dose by at least 10% can significantly reduce the symptoms of the disease. In case of abdominal discomfort and mild diarrhea, sedatives, antispasmodics, drugs that improve the consistency of feces, local analgesics, warm sitz baths, and adequate nutrition are prescribed. It is very important to be observed at this stage and constantly monitor the treatment. In case of watery diarrhea caused by impaired absorption of bile acids, the condition can be improved by prescribing cholestyramine (4-12 g per day).

In severe early manifestations of radiation damage to the intestine, especially in children, a gluten-free diet, cow's milk protein and lactose in some cases give a favorable effect. Significant irradiation in connection with large neoplasms, occurring with anorexia and weight loss, requires parenteral enhanced nutrition. Patients with radiation enteritis and enterocolitis of a severe course with a pronounced disorder of intestinal absorption are treated, in addition to parenteral nutrition, with anabolic hormones, vitamins, calcium, iron and other substances, the deficiency of which occurs in the specified form of diseases. Enzyme and desensitizing agents are prescribed, as well as drugs that normalize the intestinal microflora. In case of intestinal bleeding, iron is recommended orally or parenterally, and, if necessary, blood transfusions. Profuse bleeding is rare and requires surgical intervention. Surgical treatment is also resorted to in case of strictures, abscesses and fistulas.

Prevention of radiation enteritis and enterocolitis consists of observing safety regulations when in contact with sources of ionizing radiation, carefully working out individual doses of radiation using different types of tests for the radiosensitivity of organs and tissues. The following are important: methods of multi-field, cross, mobile irradiation, protective blocks, filters, rasters, wedges; changing the value of a single dose and the duration of intervals between radiation therapy sessions, split courses of irradiation; methods that allow healthy tissue to be mechanically moved away from the tumor; creating artificial hypoxia and prescribing radiosensitizing substances - oxygen, nitrofurans, etc.

The prognosis for radiation reactions of the intestine is usually favorable. In severe lesions of the small and large intestine, it is much more serious and depends on a number of factors (the method of irradiation, the localization and extent of the pathological process for which radiation therapy was performed, the severity of intestinal manifestations, etc.).

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