Radiation proctitis as a differential of lower GIT bleeding in Nigeria: A case series

Abstract

Pelvic radiotherapy is an acceptable and promising treatment modality for various pelvic malignancies. However, it is associated with radiation-induced injury on surrounding structures with a preference for the rectum, which is characteristically fixed in the pelvic region. Acute radiation proctitis is usually self-limiting, but in its chronic form, it can be debilitating. Recent advances in radiation therapy have significantly reduced the prevalence of radiation proctitis (RP) in high-income countries, contrary to the findings in low and middle-income countries witnessing an increasing burden of radiation proctitis. This observation can be attributed to the increased availability of radiation therapies with limited use of novel technologies designed to reduce the detrimental effects of radiotherapy and improve the detection of RP owing to improvements in endoscopic services in developing countries. This is a highlight of the trends in the presentation of RP, management modalities in various tertiary centers in Nigeria, and the limitations in care occasioned by the non-availability of argon plasma coagulation (APC) as an effective treatment modality in most tertiary health facilities in Nigeria.