Opiate antagonists can reduce diarrhea in these patients and bleeding can be ameliorated with a 4-week course of oral metronidazole or sucralfate enema treatments.1,6 Fecal incontinence can be more challenging, although there is limited evidence that phenylephrine gel may help. One very small prospective, controlled study of 19 patients
found that fecal incontinence declined among patients who received oral vitamin A (retinol palmitate, 10,000 IU/d for 90 days).1,6,8 ONA
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Bryant Furlow is a medical journalist based in Albuquerque, New Mexico.
REFERENCES
1. Andreyev HJ. Gastrointestinal problems after pelvic radiotherapy: the past, the present and the future. Clin Oncol. 2007;19(10):790-799.
2. Henson CC, Andreyev HJ, Symonds RP, et al. Late-onset bowel dysfunction after pelvic radiotherapy: a national survey of current practice and opinions of clinical oncologists. Clin Oncol. 2011;23(8):552-557.
3. Maeda Y, Høyer M, Lundby L, Norton C. Faecal incontinence following radiotherapy for prostate cancer: a systematic review. Radiother Oncol. 2011;98(2):145-153.
4. Andreyev HJ, Wotherspoon A, Denham JW, Hauer-Jensen M. Defining pelvic-radiation disease for the survivorship era. Lancet Oncol. 2010;11(4):310-312.
5. Benton B, Norton C, Lindsay JO, et al. Can nurses manage gastrointestinal symptoms arising from pelvic radiation disease? Clin Oncol. 2011;23(8):538-551.
6. Fuccio L, Guido A, Andreyev HJ. Manage-ment of intestinal complications in patients with pelvic radiation disease. Clin Gastroenterol Hepatol. 2012;10(12):1326-1334.
7. Denton AS, Andreyev HJ, Forbes A, Maher EJ. Systematic review for nonsurgical interventions for the management of late radiation proctitis. Br J Cancer. 2002;87(2):134-143.
8. Ehrenpreis ED, Jani A, Levitsky J, et al. A prospective, randomized, double-blind, placebo-controlled trial of retinol palmitate (vitamin A) for symptomatic chronic radiation proctopathy. Dis Colon Rectum. 2005;48(1):1-8.
