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Chronic Radiation Enteritis Diarrhoea — SCE Palliative Medicine MCQ

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HardGI SymptomsChronic Radiation Enteritis DiarrhoeaSCE Palliative Medicine

A patient with chronic diarrhoea two years after pelvic radiotherapy has a SeHCAT result consistent with bile-acid malabsorption. Loperamide gives incomplete control. Which targeted treatment is most appropriate?

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Correct answer: D — Start a bile-acid sequestrant

Pelvic radiotherapy can cause terminal-ileal bile-acid malabsorption. When this is demonstrated or strongly suspected, a bile-acid sequestrant such as colestyramine or colesevelam targets the mechanism; antidiarrhoeal treatment and dietetic support may continue. Antibiotics are reserved for diagnosed bacterial overgrowth, and parenteral nutrition is for severe intestinal failure.

Reference: https://www.bsg.org.uk/clinical-resource/bsg-guidance-on-the-management-of-acute-and-chronic-gastrointestinal-symptoms-and-complications-as-a-result-of-treatment-for-cancer