Overview of Radiation Enteritis

Radiation is used in the treatment of cancer and comes with risks. Radiation enteritis is one of these risks. This condition is caused by the inflammation of your small and/or large intestine from radiation treatments in your stomach, sexual organs, or rectum.

Radiation enteritis can cause the loss of both intestinal cells and tissue.

There are two types of radiation enteritis: acute and chronic. Acute enteritis develops while you are getting radiation treatments. The condition will last until about eight weeks after your last radiation treatment. Chronic enteritis can cause symptoms that last for months to years after you complete your radiation treatment.

Symptoms of enteritis include:

  • nausea
  • vomiting
  • stomach cramping
  • frequent urges to use the bathroom
  • watery diarrhea
  • mucous discharge from the rectum
  • rectal pain
  • rectal bleeding
  • weight loss
  • wave-like stomach pains

The following factors can affect your chances of developing radiation enteritis:

  • radiation dosage and duration of treatment
  • size and severity of tumor being treated
  • size of the treatment area
  • chemotherapy
  • prior stomach surgery
  • high blood pressure
  • diabetes
  • pelvic inflammatory disease or endometriosis
  • improper nutrition

Your doctor will mainly ask you questions about your bowel movements if they suspect that you have enteritis. They will want to know when your diarrhea started, how long it lasted, what the diarrhea looks like, whether there was any blood in the stool, and how often you have to use the bathroom. Your doctor will also ask about your current diet and medications you are taking.

In addition to a physical exam, some of the following diagnostic tests may be recommended:

  • endoscopy: a lighted tube is inserted into the mouth so doctors can view the upper part of the small intestine
  • colonoscopy: a lighted tube is entered into the colon, so doctors can get a view of the lower part of the small intestine
  • capsule endoscopy: you will swallow a small pill that contains a camera, which allows the doctor to view sections of the small intestine that other methods cannot see
  • Other imaging tests, such as an abdominal CT scan or a set of x-rays of the abdomen known as an upper gastrointestinal series.

Some common treatments for enteritis include:

  • antidiarrheal medicine
  • steroids
  • strong pain relief medicine like hydrocodone
  • lactose-free and low-fat diet
  • antibiotics to treat any excess bacteria within the intestines

Doctors will often suggest that people affected by radiation enteritis make changes in their diet. These changes are designed to lessen aggravation to the digestive system.

Foods to Avoid

The following foods should be on your “do not eat” list:

  • dairy products (with the exception of yogurt)
  • whole wheat bread
  • greasy foods
  • nuts
  • seeds
  • raw vegetables
  • popcorn
  • strong spices and herbs
  • coffee
  • chocolate
  • alcohol
  • tobacco products

Foods to Include

Including the following foods in your diet will help:

  • fish
  • chicken, (and meat that has been cooked, broiled, or roasted)
  • bananas
  • eggs
  • applesauce
  • white bread
  • potatoes
  • macaroni
  • mild cooked vegetables (wax beans, carrots, spinach)
  • apple and grape juices

Work with your doctor to come up with a diet plan that will help you manage your symptoms.

Most people are able to treat enteritis with dietary changes alone. However, if there is severe damage to your intestines, you may need intestinal bypass surgery. This is a surgical procedure where the damaged parts of your intestine are removed and the healthy parts are connected. This is relatively rare.

When you go through radiation treatment, your doctor will take steps to reduce the chances of enteritis. These prevention methods may include:

  • putting your body in the best position to protect your small intestines while receiving radiation
  • giving radiation treatment while you have to urinate
  • adjusting the amount of radiation delivered
  • placing clips at tumor site to make sure there is a more direct radiation dose