2nd order laboratory parameters – depending on the results of the medical history, physical examination, etc. – for differential diagnostic clarification Small blood count Differential blood count Inflammatory parameter – CRP (C-reactive protein) Electrolytes – sodium, potassium Pancreatic parameters – amylase, elastase (in serum and stool), lipase. Liver parameters – alanine aminotransferase (ALT, GPT), aspartate … Radiation Enteritis: Test and Diagnosis
Therapeutic Targets Improvement of the symptomatology Rehydration (fluid balance) Therapy recommendations Symptomatic therapy including fluid replacement – oral rehydration for signs of dehydration (fluid deficiency; > 3% weight loss): administration of oral rehydration solutions (ORL), which should be hypotonic, between meals (“tea breaks”) for mild to moderate dehydration. Compensation of electrolyte losses If necessary, symptomatic … Radiation Enteritis: Drug Therapy
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics, and obligatory medical device diagnostics – for differential diagnostic clarification. Abdominal sonography (ultrasound examination of abdominal organs) – for basic diagnostics. Colonoscopy (colonoscopy) – to exclude tumors. Gastroscopy (gastroscopy) – to exclude tumors. Computed tomography (CT; sectional imaging procedure … Radiation Enteritis: Diagnostic Tests
1st order Partial resections of affected bowel segments for obstruction (narrowing), fistula formation (false duct formation) possible.
For prevention of radiation enteritis (radiation disease of the small intestine), the smallest possible radiation window should be selected.
Acute enteritis can occur relatively quickly after radiotherapy (radiation therapy), presenting with nausea, diarrhea (diarrhea), and colicky pain. After radiation therapy is completed, symptoms usually resolve rapidly. The following symptoms and complaints may indicate radiation enteritis (radiation disease of the small intestine): Leading symptoms Diarrhea (diarrhea); possibly with blood/mucous discharges. Nausea (nausea)/vomiting. Meteorism (flatulence) Tenesmus … Radiation Enteritis: Symptoms, Complaints, Signs
Pathogenesis (development of disease) In radiation enteritis, the application of radiation causes acute inflammation of the intestinal mucosa. This can limit the absorption surface for nutrients (macro- and micronutrients). In addition, the goblet cells (mucus-producing cells) empty, and mucus is discharged with the stool. Late damage from radiation therapy occurs due to sclerosis (hardening) of … Radiation Enteritis: Causes
Regular check-ups Regular medical checkups Nutritional medicine Adherence to the following specific nutritional recommendations during illness: If steatorrhea (fatty stools) occur during radiation enteritis, the following measures should be followed: If underweight, aim for weight gain. Increased intake of fat-soluble vitamins A, D, E and K. Increased supply of omega-3 and -6 fatty acids (alpha-linolenic … Radiation Enteritis: Therapy
Medical history (history of illness) represents an important component in the diagnosis of radiation enteritis (radiation disease of the small intestine). Family history Is there a frequent history of gastrointestinal tract disease in your family? Social history Current medical history/systemic history (somatic and psychological complaints). Have you noticed any gastrointestinal symptoms such as nausea, vomiting, … Radiation Enteritis: Medical History
Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Abetalipoproteinemia (synonym: homozygous familial hypobetalipoproteinemia, ABL/HoFHBL) – genetic disorder with autosomal recessive inheritance; severe form of familial hypobetalipoproteinemia characterized by deficiency of apolipoprotein B48 and B100; defect in the formation of chylomicrons leading to fat digestion disorders in children, resulting in malabsorption (disorder of food absorption). Cronkhite-Canada syndrome … Radiation Enteritis: Or something else? Differential Diagnosis
Radiation-induced impairment of mucosa cells (mucosal cells) leads to impaired small and large bowel function. As a result, depending on the degree of mucosal damage, food components can only be insufficiently absorbed (assimilated). This primarily affects: Fat-soluble vitamins A, D, E, K. Vitamin B9 Vitamin B12 Vitamin C Magnesium Phosphorus Iron Copper Molybdenum Selenium Zinc … Radiation Enteritis: Nutritional Therapy
The following are the most important diseases or complications that may be contributed to by radiation enteritis (radiation disease of the small intestine): Endocrine, nutritional, and metabolic diseases (E00-E90). Malnutrition Underweight Mouth, esophagus (food pipe), stomach and intestines (K00-K67; K90-K93). Dysbiosis (imbalance of intestinal flora). Fistula formation* Malabsorption – disruption of the absorption of food … Radiation Enteritis: Complications