Treatment of Chronic Radiation Proctitis
Publication Date: October 1, 2018
Recommendations
Evaluation of Chronic Radiation Proctitis
A disease-specific history and physical examination should be performed, emphasizing the degree and duration of bleeding. (1C)
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Prophylactic measures, such as pedicled omental flap and tissue expander implant, have been described to decrease the incidence of radiation proctitis. These techniques are insufficiently evaluated and are not routinely recommended. (1C)
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Medical Treatments
Formalin application is an effective treatment for bleeding in patients with CRP. (1B)
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Sucralfate retention enemas are a moderately effective treatment for rectal bleeding resulting from CRP. (1C)
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Short chain fatty acid enemas are not effective in preventing or treating chronic hemorrhagic radiation proctitis and are not recommended. (1B)
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Alternative treatments such as mesalamine, ozone therapy, and metronidazole have not been adequately evaluated in treating radiation proctitis and are not recommended. (1C)
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Interventional Treatments
Endoscopic argon beam plasma coagulation is a safe and effective treatment for rectal bleeding induced by CRP. (1B)
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Hyperbaric oxygen therapy is an effective treatment modality to reduce bleeding in patients with CRP. (1B)
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Endoscopic bipolar electrocoagulation, radiofrequency ablation, Nd-YAG laser, and cryotherapy are alternative treatments of rectal bleeding from CRP that have been insufficiently evaluated and are thus not recommended. (1C)
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Title
Treatment of Chronic Radiation Proctitis
Authoring Organization
American Society of Colon and Rectal Surgeons
Publication Month/Year
October 1, 2018
External Publication Status
Published
Country of Publication
US
Inclusion Criteria
Female, Male, Adult, Older adult
Health Care Settings
Hospital, Operating and recovery room, Outpatient, Radiology services
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Scope
Assessment and screening, Management, Treatment
Diseases/Conditions (MeSH)
D011349 - Proctitis, D000071077 - Surgical Oncology
Keywords
hematochezia, Chronic Radiation Proctitis, tenesmus
Source Citation
Paquette, Ian M. M.D.1; Vogel, Jon D. M.D.2; Abbas, Maher A. M.D.3; Feingold, Daniel L. M.D.4; Steele, Scott R. M.D., M.B.A.5; On behalf of the Clinical Practice Guidelines Committee of The American Society of Colon and Rectal Surgeons The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Treatment of Chronic Radiation Proctitis, Diseases of the Colon & Rectum: October 2018 - Volume 61 - Issue 10 - p 1135-1140 doi: 10.1097/DCR.0000000000001209
Methodology
Number of Source Documents
56
Literature Search Start Date
January 1, 1990
Literature Search End Date
October 26, 2017