Prophylaxis of radiotherapy induced diarrhea after irradiation of the pelvis or the abdomen

Radiotherapy induced diarrhea and convulsive pain are severe side-effects of irradiation of the pelvis and the abdomen leading often to an interruption of the treatment. Up to now these side-effects were only treated symptomatically, prophylactic therapies are not known. During the years 1992 and 1993 174 patients who obtained radiotherapy in the pelvis or the abdomen because of different malignancies were observed referring to the diarrhea-prophylactic effect of Smectite (=SkilpinR). 80 patients received Smectite at the beginning of radiotherapy, 94 patients of the controlgroup were treated with motility modifying drugs when diarrhea appeared. The following parameters were compared: Frequency, consistence and incontinence of stool, tenesmus and the onset of diarrhea. 67,0% (n=63) of the patients in the controlgroup developed diarrhea, whereas in the pretreated Smectite-group only 37,5% of the cases (n=30) developed diarrhea. The first appearance of diarrhea was at day 17 in the pretreated group and averagely at day 11 in the controlgroup. 44% of the patients in the controlgroup suffered from tenesmus versus 25% in the Smectite-group. In comparison to the symptomatic treatment of radiation enteritis the prophylactic application of Smectite is able to reduce the diarrhea from the beginning of raditherapy or at least to reduce the pathological frequency of stool and therefore to increase the quality of life. (orig.)