Recent advances in the management of radiation colitis

Table 1 Management of acute radiation colitis

Management of acute radiation colitis
Supportive management
Anti-diarrheal medications and by reducing fat and lactose intake;
In intractable cases hospitalization is required for parenteral feeding and elementary diet
Elk-1 inhibitors
Compound A (CpdA)
U0126 [1,4-diamino-2,3-dicyano-1,4-bis(2-aminophenylthio) butadiene]
Modulation of leukocyte recruitment and activation pathway
Targeting P-selectin and/or lymphocyte function antigen-1
Cu/Zn-SOD1 supplementation
Synthetic somatostatin analog octreotide
Other measures
Antiemetics
Steroid-containing suppositories
Recombinant granulocyte colony-stimulating factor in neutropenia
Epidermal growth factor

Table 2 Management of chronic radiation colitis (IL; TNF-α)

Management of chronic radiation colitis
Empirical-experimental management
Total parenteral nutrition
Anti-IL-6R
Cyclooxygenase-2 inhibitors
Rho kinase inhibitors
Small molecular inhibitors of TNF-α
Targeting cadherin-catenin complex pathways
Recombinant human IL-11
Low-residue diet combined with bismuth subsalicylate or opiate drugs, such as loperamide or diphenoxylate (for mild diarrhea)
Aminosalicylates
Prostaglandin-inhibiting compounds
Oral steroids (for severe cases)
Probiotics (Lactobacillus bulgaricus)
Antioxidants
Colestyramine Balsalazide (in radiation-induced proctosigmoiditis)
Peroxisome proliferation-activated receptor activators
Sucralfate enemas
Short-chain fatty acids
Hyperbaric oxygen
Control of bleeding (by endoscopic cauterization using a heater, BICAP probe, Nd: YAG or argon laser)
Surgery (indicated in intestinal obstruction, perforation, fistulas, and severe bleeding)