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Radiation Oncology pp 1–16Cite as

Gastrointestinal Toxicity

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Abstract

The increasing use of modern and intensified radiation therapy requires the awareness of the treating physician of acute and late side effects in the GI tract to not miss the optimal time for intervention and supportive measures.

As a basic principle, a perfect nutrition by either oral (i.e., gastrostomy feeding tube) or parenteral access should be secured. Acute esophagitis should be treated according to symptoms, with local or systemic analgesic agents, and by promotility agents and proton pump inhibitors to reduce an acid reflux. Late esophagitis is usually a stricture and can be treated by repeated endoscopic dilatation.

The acute and chronic enteritis is symptomatically treated with stool softeners against obstipation and loperamide against diarrhea or octreotide for treatment-resistant diarrhea.

Radiation proctitis may be prevented by amifostine (i.v. or rectal enema), but it has to be balanced against the overall clinical effort. Sulfasalazine for the prevention of enteritis and proctitis is under controversial discussion, and its use should be carefully indicated. Acute and predominantly late proctitis is treated by a sequence of local measures as sucralfate enema, local formalin, endoscopic coagulation, traditional Chinese medicine, and hyperbaric oxygen in chronic situations. Stool softeners for obstipation and loperamide for diarrhea can be used in both acute and late proctitis. Surgery is limited for therapy-resistant situations of late proctitis only.

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Authors and Affiliations

  1. Clinic of Radiotherapy and Radiation Oncology, University Hospital Basel, Basel, Switzerland

    Frank Zimmermann

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  1. Frank Zimmermann
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Correspondence to Frank Zimmermann .

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Editors and Affiliations

  1. Department of Radiation Oncology, University Hospital Mannheim, Mannheim, Germany

    Frederik Wenz

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Zimmermann, F. (2020). Gastrointestinal Toxicity. In: Wenz, F. (eds) Radiation Oncology. Springer, Cham. https://doi.org/10.1007/978-3-319-52619-5_108-1

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  • DOI: https://doi.org/10.1007/978-3-319-52619-5_108-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-52619-5

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