ABSTRACT
Radiation-induced damage to the gut occurs most frequently following radiotherapy for pelvic or abdominal malignancy. The amount of damage to the bowel depends upon the total cumulative dose of radiation (>4000 rads) and the size of the area irradiated. Previous abdominal surgery increases the risk because the bowel is often fixed by adhesions, thus subjecting the same loops of bowel to the field of irradiation. Both the small and large bowel may be affected, with the ileum being most susceptible. The damage mainly affects the submucosal layer, and hence is not always detected by routine biopsies. With time an endarteritis develops resulting in ischaemia. Patients may experience symptoms at the time of radiotherapy or at some later stage.
