Colon & Rectal Surgery

Rectal Cancer

Delta Medix Patient General Information

Formalin Application for Radiation Proctitis

Radiation proctitis is the inflammation and damage to the lower parts of the colon after radiation therapy secondary to the exposure of radiation. Radiation proctitis most commonly occurs after treatment for cancers such as cervical cancer, prostate cancer, and colon cancer. Radiation proctitis involves the lower intestine, primarily the sigmoid colon and rectum.

Radiation proctitis can be divided into two categories: acute and chronic. Acute radiation proctitis usually occurs within six weeks following therapy. Symptoms include diarrhea and rectal urgency with an inability to defecate. Acute radiation injury is caused by direct mucosal damage from radiation exposure and often resolves without treatment after radiation is discontinued within a few months.

Chronic radiation proctitis may begin as early as several months after radiation therapy but can occur anytime post radiation and quite often several years later. Symptoms include diarrhea and painful defecation, however, the most common problem is rectal bleeding. The lining of the rectum is often the area that is inflamed and is the cause of the rectal bleeding.

Treatment for chronic radiation proctitis can be managed through a technique of formalin application. A total colonoscopy or sigmoidoscopy is quite often performed prior to any formalin treatments to exclude other causes of rectal bleeding as well as to determine the extent of radiation damage to the rectum. A biopsy may be performed during the colonoscopy to rule out any other disease or infectious disorders.

Formalin application involves using gauze or stick sponge soaked with 4% formalin and application directly to all areas of the hemorrhagic surfaces in the rectum under a local anesthesia. This usually takes about two to three minutes per application to each area. The procedure may need to be repeated when necessary in chronic radiation proctitis if symptoms and rectal bleeding continue or reoccur.