Effects of radiation on the digestive tract

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Classification according to ICD-10
T66 Unspecified damage from radiation
K52.0 Gastroenteritis and colitis due to radiation exposure
ICD-10 online (WHO version 2019)

This article deals with the radiation effects on the digestive tract , as complications of radiotherapy occur. A general distinction is made between acute and late complications. Acute side effects are those that occur between the first and the ninetieth day. Long-term effects only become noticeable after the ninetieth day.

The acute consequences of radiation mainly take place on the mucous membrane of the gastrointestinal tract. Since the cells of the mucous membrane are in constant renewal, they are sensitive to radiation. But this also means that acute radiation effects are reversed in a short time.

The chronic long-term effects of radiation are mainly based on impairment of the vessels as well as thrombosis and fibrosis . The vascular damage is progressive and represents a serious complication. It ultimately causes chronic radiation disease.

The radiation diseases of the esophagus

The high-dose irradiation of the esophagus occurs mostly in tumors of the esophagus and bronchial carcinoma . The acute reaction is usually pain and inflammation of the esophagus ( esophagitis ). Difficulty swallowing is observed after high dosages. It is important to note that the psychological situation also determines the extent of the complaints. Bleeding, perforation of the esophagus and the formation of fistulas can result as complications . The chronic consequence of radiation can be a narrowing or obstruction of the esophagus. Treatment is difficult and often frustrating.

Radiation disease of the stomach

The healthy stomach is often also irradiated as part of an irradiation of the upper abdomen. The formation of hydrochloric acid is acutely reduced or it stops completely. This irritation lasts between 1 and 6 months, but can last for years. Chronic radiation damage includes indigestion, inflammation of the stomach lining ( gastritis ), stomach ulcers and narrowing of the stomach passage.

Radiation disease of the small and large intestines

Image of a recent bleeding from radiation proctitis. The extensive bleeding site is remarkable

After irradiation, acute enteritis occurs relatively quickly , which manifests itself in nausea, colicky pain and diarrhea. However, symptoms resolve quickly after radiotherapy is stopped. The long-term effects of radiation are bleeding, ulcers, narrowing and obstruction of the intestines and fistulas. The earlier the long-term effects occur, the more severe they are. 2–5% of patients require surgery. The most common locations for long-term sequelae are the rectum and the sigmoid colon after irradiation of prostate carcinomas , bladder tumors or gynecological tumors.

See also

Radiation colitis


K. Schnabel et al. in Clinical Gastroenterology . Pp. 1049-1055