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World J Gastrointest Oncol. May 15, 2021; 13(5): 400-408
Published online May 15, 2021. doi: 10.4251/wjgo.v13.i5.400
Update on the management of the gastrointestinal effects of radiation
Hannah McCaughan, Stephen Boyle, John J McGoran
Hannah McCaughan, Stephen Boyle, John J McGoran, Department of Gastroenterology, Altnagelvin Area Hospital, Londonderry BT47 6SB, United Kingdom
Author contributions: McCaughan H and Boyle S were involved in gathering recent evidence for this review; McGoran JJ reviewed the manuscript and made additions; All were involved in the writing of the completed manuscript.
Conflict-of-interest statement: There are no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: John J McGoran, MBChB, MSc, Doctor, Department of Gastroenterology, Altnagelvin Area Hospital, Glenshane Road, Londonderry BT47 6SB, United Kingdom. jmcgoran01@qub.ac.uk
Received: February 18, 2021
Peer-review started: February 18, 2021
First decision: March 15, 2021
Revised: March 28, 2021
Accepted: April 5, 2021
Article in press: April 5, 2021
Published online: May 15, 2021
Processing time: 77 Days and 11 Hours
Abstract

Radiation therapy is a long-established and essential modality in the treatment of many cancers. It is well known that tissue within a field of radiation can suffer indiscriminate effects, leading to acute and chronic problems. The gastrointestinal tract may be adversely affected by radiation. From the mouth to the rectum, patients can experience troublesome symptoms that require the concerted input of specialist teams. Interventions range from nursing care, dietetic optimization, pharmacological management, and mechanical procedures through endoscopy and surgery. Quality evidence exists mainly for radiation induced effects in four distinct areas of the gastrointestinal tract: oral mucosa, esophagus, small bowel, and rectum. This review explores the experiences of oncology and gastrointestinal teams in managing the most common conditions and some of the different practices for radiation associated morbidity.

Keywords: Radiation; Stricture; Endoscopy

Core Tip: With growing numbers of patients worldwide undergoing radiation therapy for cancer, addressing the gastrointestinal effects of this is an essential area for development. Pharmacological, endoscopic, and surgical approaches continue to develop, but basic measures such as optimizing nutrition are often central to patient care.