Is this condition an ‘-itis’ or an ‘-opathy’
or is it Pelvic Radiation Disease (PRD)?
A survey of gastroenterology professionals on what terminology they use for gastrointestinal problems after pelvic radiotherapy
PRDA is frequently contacted by people who have been told that their long-term bowel problems are due to radiation-induced ‘proctitis’, ‘enteritis’ or ‘colitis’.
None of these terms are correct. Having ‘-itis’ at the end of the word simply means that there is inflammation. The biological changes that happen as a result of irreversible radiation injury to the gastrointestinal tract are not limited to inflammation, but encompass a range of disease processes which produce a range of symptoms. It is therefore more correct to say for bowel problems, because ‘-opathy’ means a more general disorder of a body part. Similarly, for bladder problems, it is better to say radiation cystopathy than radiation cystitis.
In order to gauge the extent to which ‘Pelvic Radiation Disease’ had become known and accepted in the gastroenterology professional community, PRDA conducted a poll amongst 164 visitors to PRDA’s exhibition stand at the British Society of Gastroenterology 2019 Glasgow conference. These conference delegates (mostly doctors) were asked “What do you call gastrointestinal symptoms caused by pelvic radiotherapy?” and were shown a choice of answers, and/or could add their own.
Many chose more than one response to the question (see Table 1) – seven different terms were in use, and many professionals appeared to use more than one term.
Table 1. Responses given by a sample of visitors (n = 164) at the largest UK annual gastroenterology conference (BSG 2019) to the question “What do you call gastrointestinal symptoms caused by pelvic radiotherapy?”
|Choice of answer to the question||Number of responses (%)|
|Radiation Proctitis||116 (40%)|
|Radiation Enteritis||51 (18%)|
|Radiation Colitis||44 (15%)|
|Pelvic Radiation Disease||37 (13%)|
|Radiation Enteropathy||30 (11%)|
|I do not diagnose this disorder||6 (2%)|
|Radiation Proctopathy*||2 (1%)|
|Radiation Enterocolitis*||1 (1%)|
Note: some people provided more than one answer.
*Terms that were provided by respondents.
Conclusion and comment:
It is clear from this survey in 2019 that a standard terminology is not yet established amongst gastroenterology professionals. This is despite radiation-induced bowel problems being increasingly prevalent and having severe impacts on quality of life, as described in the British Society of Gastroenterology guidance on acute and chronic effects of cancer treatment published in 2012.
If doctors continue to use the ‘-itis’ terminology then it is likely that they will not fully grasp the extent of different bowel symptoms that people can experience (see PRD definition) and the complexity of fully investigating, diagnosing and treating these symptoms.
Diagnosing and recording ‘Pelvic Radiation Disease’ correctly and consistently in health records would be an important step towards better managing the impact of this devastating condition.
In addition, professionals should talk to patients about PRD and signpost them to sources of support (such as PRDA), as this will help patients to understand and take more control over their symptoms, and to benefit from peer support.
Modified: 7th January 2021