#JustReleased ASCRS 2018 Guidelines for Rx of Chronic Radiat
The American Society of Colon and Rectal Surgeons (ASCRS) has recently released clinical practice guidelines for the treatment of chronic radiation proctitis (CRP). Chronic hemorrhagic radiation proctitis is a syndrome marked by hematochezia, mucus discharge, tenesmus, and, often, fecal incontinence. Current estimates are that 1-5% of patients treated with radiation for pelvic malignancy experience chronic radiation proctitis.

“It is important to review the history of the primary disease process and the radiation dose received. Because the most common indications for pelvic radiation therapy are malignancies (anal cancer, uterine cancer, cervical cancer, prostate cancer, and rectal cancer), it is important to assess the patient for recurrence of his or her primary cancer with physical examination or imaging where appropriate. At a minimum, a digital rectal examination should be performed to evaluate sphincter tone, as well as a proctoscopic examination to evaluate the quality of the mucosa, distribution of disease, and to rule out malignancy”, the authors write in the guidance document published in the journal Diseases of the Colon and Rectum.

Some of the key recommendations are:-
• A disease-specific history and physical examination should be performed, emphasizing the degree and duration of bleeding

• Formalin application is an effective treatment for bleeding in patients with CRP

• Sucralfate retention enemas are a moderately effective treatment for rectal bleeding

• Short chain fatty acid enemas are not effective in preventing or treating and are not recommended

• Endoscopic argon beam plasma coagulation is a safe and effective treatment for rectal bleeding induced by CRP

• Hyperbaric oxygen therapy is an effective treatment modality to reduce bleeding in patients with CRP

• Endoscopic bipolar electrocoagulation, radiofrequency ablation, Nd-YAG laser, and cryotherapy are alternative treatments of rectal bleeding from CRP are not recommended

The American Society of Colon and Rectal Surgeons (ASCRS), formerly the American Proctologic Society, is a professional society for surgeons specializing in colorectal surgery. It is one of the older surgical societies, having been established in 1899. It is dedicated to assuring high-quality patient care by advancing the science, prevention, and management of disorders and diseases of the colon, rectum, and anus.

Note: This list is a brief compilation of some of the key recommendations and does not constitute medical advice. Kindly refer to the original publication here: https://journals.lww.com/dcrjournal/Fulltext/2018/10000/The_American_Society_of_Colon_and_Rectal_Surgeons.4.aspx