A RETROSPECTIVE STUDY OF THE EFFECTS OF PELVIC IRRADIATION FOR CARCINOMA OF THE CERVIX ON GASTROINTESTINAL FUNCTION

Purpose: To evaluate the prevalence of disordered gastrointestinal fun ction following therapeutic irradiation. Methods and Materials: Gastro intestinal function was evaluated in 30 randomly selected patients who had received pelvic irradiation for treatment of carcinoma of the cer vix between 1 and 6 years previously. Each patient underwent evaluatio ns of (a) gastrointestinal symptoms (b) absorption of bile acid, vitam in B12, lactose and fat (c) gastrointestinal transit: gastric emptying , small intestinal transit and whole gut transit and (d) intestinal pe rmeability. Results were compared with those obtained in 18 normal vol unteers. Results: Stool frequency was above the control range in five patients and had increased (p < 0.001) since radiotherapy treatment. B ile acid (p < 0.001) vitamin B12 (p < 0.01) and lactose (p < 0.01) abs orption were less in the patients when compared with the control subje cts. Bile acid absorption was below the control range in 14 of the 30 patients. Dietary calcium intake was lower (p < 0.05) in those patient s with lactose malabsorption. Gastric emptying (p < 0.01) and small in testinal transit (p < 0.01) were more rapid in the patients. Both smal l intestinal (r = -0.39, p < 0.05) and whole gut (r = -0.45) transit w ere inversely related to stool frequency. Either bowel frequency, bile acid absorption, vitamin B12 absorption was outside the control range in 19 of the 30 patients. Conclusion: Abnormal gastrointestinal funct ion is essentially an inevitable long-term sequel of pelvic irradiatio n.