Start a low residue diet on day 1 of radiation therapy treatment. Reston Publishing Company, Inc., 1982. Signs and symptoms include colicky abdominal pain, bloody diarrhea, tenesmus, steatorrhea, weight loss, and nausea and vomiting. The initial signs and symptoms occur within 6 to 18 months following radiation therapy. Ulceration is common, varying from simple loss of epithelial layers to ulcers that may penetrate to different depths of the intestinal wall, even to the serosa.
Lymphatic tissue is often atrophic or absent.
The submucosa is severely diseased. Arterioles and small arteries show profound changes with hyalinization of the entire wall thickness. The muscularis is often distorted or focally replaced by fibrosis. The diagnosis of chronic radiation enteritis may be difficult to make. Clinically and radiologically recurrent tumor needs to be ruled out.