Radiation Injury in the Gastrointestinal Tract

Modern techniques for tomographic localization and fractionation of radiation therapy have significantly reduced short-term and long-term gastrointestinal (GI) morbidity resulting from radiation therapy. Radiation damage to the vascular endothelium of the GI tract has been strongly implicated in contributing to radiation-induced GI tract injury. Intestinal trefoil factors (ITF) has shown promise in mitigating the effects of radiation injury or chemotherapy when ITF was administered orally prior to radiation and chemotherapy treatment. The earliest recognizable histological features following radiation injury to the GI tract occur within hours and include apoptosis of lamina propria lymphocytes and epithelial cells, the cessation of epithelial cell replication, and damage to vascular endothelial cells. Radiation proctosigmoiditis is among the most common complications of radiation injury. Many gynecological and urological tumors are treated with radiation, and the relatively fixed location of the rectum makes it more susceptible to radiation injury than the rest of the colon.