Review
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World J Gastroenterol. Jan 14, 2013; 19(2): 185-198
Published online Jan 14, 2013. doi: 10.3748/wjg.v19.i2.185
Gastrointestinal radiation injury: Symptoms, risk factors and mechanisms
Abobakr K Shadad, Frank J Sullivan, Joseph D Martin, Laurence J Egan
Abobakr K Shadad, Laurence J Egan, Department of Gastroenterology, University Hospital Galway, University Hospital Galway, 34562 Galway, Ireland
Abobakr K Shadad, Laurence J Egan, Department of Pharmacology and Therapeutics, School of Medicine, University Hospital Galway, 34562 Galway, Ireland
Frank J Sullivan, Joseph D Martin, Department of Radiation Oncology, National University of Ireland Galway, University Hospital Galway, 34562 Galway, Ireland
Author contributions: Shadad AK wrote the review; Sullivan FJ, Martin JD and Egan LJ revised the contents.
Correspondence to: Laurence J Egan, Professor, Department of Pharmacology and Therapeutics, School of Medicine, University Hospital Galway, 34562 Galway, Ireland. laurence.egan@nuigalway.ie
Telephone: +353-91-495370 Fax: +353-91-495572
Received: December 4, 2011
Revised: March 31, 2012
Accepted: December 15, 2012
Published online: January 14, 2013
Abstract

Ionising radiation therapy is a common treatment modality for different types of cancer and its use is expected to increase with advances in screening and early detection of cancer. Radiation injury to the gastrointestinal tract is important factor working against better utility of this important therapeutic modality. Cancer survivors can suffer a wide variety of acute and chronic symptoms following radiotherapy, which significantly reduces their quality of life as well as adding an extra burden to the cost of health care. The accurate diagnosis and treatment of intestinal radiation injury often represents a clinical challenge to practicing physicians in both gastroenterology and oncology. Despite the growing recognition of the problem and some advances in understanding the cellular and molecular mechanisms of radiation injury, relatively little is known about the pathophysiology of gastrointestinal radiation injury or any possible susceptibility factors that could aggravate its severity. The aims of this review are to examine the various clinical manifestations of post-radiation gastrointestinal symptoms, to discuss possible patient and treatment factors implicated in normal gastrointestinal tissue radiosensitivity and to outline different mechanisms of intestinal tissue injury.

Keywords: Radiation enteritis, Radiation proctitis, Symptoms, Pathophysiology, Risk factors