Treatment of radiation-induced proctitis with sucralfate enemas

Treatment of radiation-induced proctitis with sucralfate enemas

OBJECTIVE: To report a case of radiation-induced proctitis treated with sucralfate enemas. CASE SUMMARY: A 77-year-old white woman was transferred from an acute care institution to our inpatient rehabilitation unit with impaired mobility and reduced activities of daily living. Her condition was seco...

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Bibliographic Details
Published in:The Annals of pharmacotherapy Vol. 33; no. 12; pp. 1274 - 1276
Main Authors: Melko, GP, Turco, TF, Phelan, TF, Sauers, NM
Format: Journal Article
Language:English
Published: Cincinnati, OH Harvey Whitney Books 01-12-1999
SAGE Publications
Whitney
Subjects:
Aged
Biological and medical sciences
Combined Modality Therapy
Digestive system
Enema
Female
Gastrointestinal Agents - administration & dosage
Gastrointestinal Agents - therapeutic use
Gastrointestinal Hemorrhage - etiology
Humans
Medical sciences
Ovarian Neoplasms - radiotherapy
Ovarian Neoplasms - therapy
Pharmacology. Drug treatments
Proctitis - drug therapy
Proctitis - etiology
Radiotherapy - adverse effects
Sucralfate - administration & dosage
Sucralfate - therapeutic use
proctitis
sucralfate enema
Human
Radiotherapy
Rectal administration
Enema
Case study
Sucralfate
Chemotherapy
Proctitis
Treatment
Digestive diseases
Intestinal disease
Complication
Anorectal disease
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Summary:OBJECTIVE: To report a case of radiation-induced proctitis treated with sucralfate enemas. CASE SUMMARY: A 77-year-old white woman was transferred from an acute care institution to our inpatient rehabilitation unit with impaired mobility and reduced activities of daily living. Her condition was secondary to myopathy and peripheral neuropathy associated with postradiation chemotherapy and metastatic ovarian carcinoma. During her stay, she developed hematochezia and pain secondary to a diagnosis of radiation-induced proctitis. Her hemoglobin had reached a nadir of 7.3 g/dL. The patient received blood transfusions and was started on 10% w/v sucralfate retention enemas 2 g/20 mL daily for 12 consecutive days. She was symptom-free at discharge, with a stable hemoglobin of approximately 10 g/dL. DISCUSSION: Proctitis is a common adverse effect of radiotherapy to the lower abdomen and pelvic area. Sucralfate is an aluminum complex that acts as a local cytoprotective agent against ulceration of the gastrointestinal mucosal lining. Rectal administration of sucralfate, as described in our patient and reported in published case studies, may provide an alternative therapy for patients with radiation-induced proctitis. CONCLUSIONS: Sucralfate suspension enemas provide a viable treatment option in patients who are intolerant of, refractory to, or not candidates for standard therapy for radiation-induced proctitis.
ISSN:1060-0280
1542-6270
DOI:10.1345/aph.19065