Update on the management of the gastrointestinal effects of radiation

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.