The rectum, because of its fixed position in the pelvis and proximity to the prostate and uterus, is the most common GI site of radiation injury (50,51). In a series of 738 patients with prostate cancer treated with radiation, proctitis of at least moderate severity was seen in 5% and anorectal stricture or fibrosis in 1% (52). The incidence of severe proctitis was less than 1%, and most presented within 2-5 years after radiation exposure. Other studies have noted rates of proctitis of up to 20%. Acute radiation injury may develop during or shortly after radiation treatment but usually resolves within 2-3 months. Chronic radiation injury is an ischemic process usually beginning 2-3 months after treatment has ended. Factors that may increase the likelihood of radiation injury include a history of lower abdominal surgery, concomitant medical illnesses predisposing to vascular disease such as diabetes or hypertension, and possibly chemotherapy (53). Total radiation dose delivered and volume of tissue exposed also play a major role in the severity and incidence of complications (54). Conformal radiotherapy techniques, which focus the high-dose volume of radiation to the affected tissue while sparing adjacent structures such as the rectum and bladder, produce fewer complications (55).
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What Is The Gluten Free Diet And What You Need To Know Before You Try It. You may have heard the term gluten free, and you may even have a general idea as to what it means to eat a gluten free diet. Most people believe this type of diet is a curse for those who simply cannot tolerate the protein known as gluten, as they will never be able to eat any food that contains wheat, rye, barley, malts, or triticale.