How is radiation enteritis treated

What are general principles of managing radiation enteritis? 

  • Medical management options are generally exhausted before surgery is contemplated or attempted.
  • Cholestyramine, elemental diets, and total parenteral nutrition are commonly used.
  • Although surgery is not withheld for urgent indications (complete obstruction, perforation, abscess not amenable to percutaneous drainage, bleeding, or unresponsive fistulas), it carries significant morbidity and mortality rates.
  • Enterolysis, or separating of adhesions, in radiated bowel is associated with a high rate of fistula formation.
  • Anastomosis can be performed safely if at least one end of bowel to be connected has not been irradiated. Intestinal bypass procedures without resection may be necessary.
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