ENDOSCOPIC TREATMENT OF CHRONIC RADIATION PROCTOPATHY

Radiation proctopathy can be a disabling delayed outcome of radiation therapy directed at pelvic malignancies. Rectal outlet bleeding can be severe enough to result in anemia and transfusion dependency. Bleedin g typically develops from 6 months to 1 year after completion of radia tion therapy and is caused by friable mucosal angioectasias. Although many approaches to controlling bleeding from chronic radiation proctop athy have been attempted, ranging from topical enema formulations to s urgical diversion of the rectum, endoscopic coagulation therapy remain s the most effective. This review provides the background issues surro unding the development of chronic bleeding radiation proctopathy and f ocuses on endoscopic methods of treatment.