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Sucralfate paste enema: a new method of topical treatment for haemorrhagic radiation proctitis
Author(s) -
McElvanna K.,
Wilson A.,
Irwin T.
Publication year - 2014
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.12507
Subject(s) - sucralfate , medicine , radiation proctitis , enema , radiation therapy , proctitis , rectum , surgery , gastroenterology , ulcerative colitis , disease
Aim Rectal sucralfate has been reported to deliver clinical improvement in haemorrhagic radiation proctitis, but patients with active proctitis find the enema suspension difficult to retain thus reducing compliance and effectiveness. We describe a novel method of rectal administration via a low‐volume sucralfate paste and report its results in a series of 23 patients. Method Patients with rectal bleeding occurring more than 6 months after radiotherapy were shown how to prepare and self‐administer sucralfate paste enemas ( SPE s) twice daily for 6 weeks. The SPE was prepared using two sucralfate 1‐g tablets mixed with 4.5 ml of water in an enema applicator producing a low‐volume paste. The clinical response was evaluated by comparison of pre‐ and posttreatment clinical proctitis scores (Radiation Therapy Oncology Group/European Organisation for Research and Treatment of Cancer). Results Eighteen male (postprostatic radiotherapy) and five female (postcervical radiotherapy) patients with a median age of 67 (32–75) years were included. The median interval between pelvic irradiation and SPE treatment was 24 (7–69) months. Twenty‐two patients had full clinical scoring, of whom 16 (73%) demonstrated clinical improvement. Six (27%) had neither clinical improvement nor deterioration. Seven (32%) had resolution of all symptoms. Conclusion Most patients demonstrated clinical improvement. This initial experience of the sucralfate paste enema may provide the basis for a prospective study of its effectiveness in the treatment of haemorrhagic radiation proctitis.