Radiation Enteritis - Medical Malpractice LawyersLEGAL HELPLINE: ☎ 855 804 7125
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Radiation Enteritis - Medical Malpractice
Radiation enteritis involves irritation and injury to the intestines from extreme exposure to X-rays. It was first discovered in 1897, two years after x-rays were discovered. Accidental radiation enteritis has become less of a problem since then as doctors discover what are the right doses of radiation for various x-ray procedures. Even so, 2-5 percent of patients who receive abdominal or pelvic radiation therapy will get some form of radiation enteritis. Radiation exposure from damaged nuclear power plants has been known to cause radiation enteritis as well. The incidence of the condition is increasing as doctors continue to push the envelope on how much radiation to give in cancerous situations.
The ten year chance for moderate problems is about 8 percent and that for severe problems is about 3 percent. Major morbidity includes obstruction of the bowel, bleeding from the lining of the colon and intestines, stenosis of the colon or intestines and fistula formation. Malabsorption is common. Peritonitis is less common but more severe. There are no differences between races, gender and age when it comes to getting radiation enteritis.
The unit dose of radiation is called the Gray unit or Gy. One Gy equals a hundred rads. You can get radiation enteritis with as little as 40 Gy but the more serious forms occur in patients who receive more than 50 Gy of radiation. The cells that are more sensitive to radiation enteritis are the dividing cells so the lining, which divides faster, is more sensitive to radiation than other cells. There needs also to be a rest between radiation treatments to allow the lining to heal and stop dividing as much as it does during the healing process.
Symptoms of radiation enteritis can be acute and can occur within hours of the treatment session. It can also occur months or years after the treatment has been completed. In the early stages, the symptoms occur within two to three weeks after exposure. They tend to get better within 2-6 months. The acute symptoms include anorexia, nausea and vomiting (especially with upper abdominal irradiation), crampy abdominal pain, diarrhoea, pain in the rectum with tenesmus (spasm of the rectum) and rectal bleeding.
Late presentation of symptoms tends to occur months to years after therapy has been discontinued. You can get chronic symptoms without ever having had acute symptoms. Chronic symptoms include abdominal colic, vomiting, chronic watery or fatty diarrhoea, vaginal discharge of air or feces due to a fistula, tenesmus, serious rectal bleeding and toxic symptoms from peritonitis.
The doctor can diagnose radiation enteritis with a complete history and physical examination. The physical can show weight loss, malnutrition, abdominal tenderness, anaemia, signs of peritonitis such as rebound tenderness, hyperactive bowel sounds and rectal bleeding.
Predisposing factors include previous surgery that has led to adhesions in the abdomen, those with high blood pressure, generalized atherosclerosis, diabetes mellitus, and those who tend to be thinner and more elderly. Chemotherapeutic agents make you more likely to have radiation enteritis. Those with underlying inflammatory disease of the colon are more susceptible to getting radiation enteritis.
The diagnosis of radiation enteritis can include looking at blood work to see if the patient has had bleeding and is anaemic. You can also see electrolyte problems, nutritional issues and kidney damage. The stool can show blood in the stool and excess fat in the stool. Plain x-rays are usually nonspecific so that barium enemas may need to be done which show the presence of fistulae and narrowed areas within the intestines. The CT scan of the abdomen can show if there are abscesses or bowel obstruction. Colonoscopy or video capsule endoscopy can be done to show areas of bleeding or damage to the lining of the bowels and intestines.
The treatment of radiation enteritis can include medications to control diarrhoea or other symptoms. Surgery is generally necessary to remove sections of bowel that are seriously damaged or to remove fistulae.LEGAL HELPLINE: ☎ 855 804 7125
The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here