XXXX : issues surrounding delayed @entity29 post-pelvic radiotherapy and an update on medical treatment.

@entity1 @entity137 @entity868 @entity5 @entity26 @entity406 @entity5418 @entity102 @entity29
Late onset @entity29 post-pelvic radiotherapy is an increasingly common clinical scenario which is related to improved oncological treatments and @entity5 survival. 50% of @entity1 develop bowel symptoms after pelvic radiotherapy which affects quality of life. Historically, bowel symptoms post-pelvic radiotherapy have been labelled ' @entity102 ', although it is increasingly recognised that these symptoms are due to dysfunction of the gastrointestinal (GI) tract at numerous points. The evidence-base is poor and comprises often small, heterogenous, single centre unblinded studies. This article critically reviews the evidence for the medical treatment options for ' @entity102 ', which include anti-inflammatory drugs, antibiotics, @entity5418 , @entity406 and hyperbaric @entity26 . The difficulties in extrapolation from the literature to clinical practise are also explored. From the available evidence, rectal sucralfate appears to have greater efficacy than anti-inflammatory agents, which are more effective if used with oral @entity868 . Furthermore, hyperbaric @entity26 is emerging as promising treatment for radiation @entity137 . However, @entity29 post-pelvic radiotherapy is a complex clinical condition which reflects multi-site GI tract pathologies both related and unrelated to previous oncological treatments. From this review article a clear need for an adjustment to both diagnosis and treatment of these @entity1 , as well as for further research, emerges.
