Radiation injury in the gastrointestinal tract

Radiation enteropathy is the most prevalent complication from radiation therapy (RT) of the abdominal and pelvic cancers and, in the United States, the patients suffering from radiation-related intestinal dysfunction far exceed those suffering from inflammatory bowel disease. Patients may present with acute symptoms days or weeks after RT is initiated or with delayed clinical syndromes that may occur years after therapy. Clinical symptoms include odynophagia, diarrhea, nausea, vomiting, or gastrointestinal bleeding; the symptoms depend on the location of the radiation field, the dose of irradiation, and the fractionation schedule. There is increased appreciation of the relatively high prevalence of bile acid malabsorption resulting from pelvic chemoradiation for cancer, presenting as loose stools. The chapter also presents a few case summaries that provide an overview on the various symptoms of radiation-induced gastrointestinal damage.