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The Old Endoscopy Quiz (and Answer) of the Month
March 2008

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Question:

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This old gentleman had been treated for prostate cancer a few years earlier. During the treatment he had some diarrhea but then the bowel function returned to normal. He now came to a colonoscopy as he had seen mucus and some blood in his stools. This is the finding in his rectum. What is this typical finding? And - and this You don´t have to answer if You are in a hurry - how would You treat this condition?

Correct answer:

Radiation proctitis

The most often suggested treatment was Argon Plasma Coagulation (APC). Other suggestions were:
* Mesalazine
* Sucralfate enemas
* Steroid enemas
* Sulfasalazine

The medical litterature knows a variety of other methods used to treat this condition, but there has not been any formal trials, which is astonishing as this is really a quite common complication to radiation therapy. . At the time this patient was examined we did not have APC. He was treated with a psyllium preparation to avoid obstipation and has been quite symptomfree since then.

Radiation proctitis

Radiation proctosigmoiditis is a frequent complication of radiation therapy used in the treatment of cervix or uterus cancer in women, prostate and testes cancer in men and urine bladder in both sexes. Every 7th patient treated for one of these diseases will have sign of chronic radiation injury in the rectum or sigmoideum. The injury is often worse in the rectum because of the high dose of radiation in this area, and more slight in the sigmoid colon. The small bowel can also be affected.

Correct answers and comments were emailed by

Dr.Virendra Parikh, Fort Wayne, USA, Indiana
Dr.ARBER Veliu, Prishtina, Kosova
Akan Kumar, Brentwood, Essex, United Kingdom
Cheryl Lynch, Erie, USA/PA
BURHAN TAM, Esenyurt-İSTANBUL, TÜRKİYE
Gustavo Pignaton de Freitas, Rio de Janeiro, Brazil
mohammad ibrarullah, Bhubaneswar, Orissa India
Cevale Karslioglu Sgouros, Istanbul, Tü,rkiye

Streets of Nisantasi in Istanbul, Turkey, at night © Cevale Karslioglu Sgouros, Istanbul, Türkiye
mario galluzzi, lecco, Italy
Mehmet Gök, kayseri, Turkey
cuartas-hoyos, augusta, USA
l kirkham, milton keynes, UK
edward, Glen Innes, Australia
mo, Cairo, Egypt
ziad daoudi, cleveland, USA
RASSIAT emmanuel, DIJON, FRANCE
traiangligor, abrud, Romania
Victor Paz, México, México, D.F.
Pham Khanh Do-Cong, Stord, Norway
Rashedhassen, fakous, Egypt
Soonmin Park, Seoul, South korea
Bekele Beyene, Tønsberg, Norway
Dr Ram Prakash Galwa, Chandigarh, India
Reza Alami, Gouthenbourg, Sweden
Hakan YAPICI, Istanbul, Türkiye
Curt Tysk, Orebro, Sweden
mehmet Ibis, Ankara/ Turkey, Turkey
Grzegorz Naprawa, Szczecin, Poland
MAJID HOSSEINIAN, TEHRAN, IRAN
Fabrizio Cereatti e Gianfranco Fanello, Rome, Italy
BURHAN TAM, Esenyurt- İSTANBUL, TÜRKİYE
PARABOLI SILVA, Marcio Luiz , Sao Jose do Rio Preto, BRAZIL
Martin Merenda, Novı Jièín, Czech rep.
DVM MAKBULE DÜNDAR / PETLAND VETERİNER HİZMETLERİ, GUZELYALI-IZMIR, TURKEY
Dori, Moline, IL -USA
Narendra Siddaiah, Jackson, MS, USA
dr.Shabbir Ahmed, Bangalore, India Karnataka
osman demirkol, Istanbul, Türkiye
James, Labrador City, Canada
pekarev, Mariupol, Ukraine
cwikla, Warsaw, Poland

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