I. General treatment: Bed rest should be given during the acute period. Diet should be non-irritating, easy to digest, nutritious, with many small meals. Restrict fiber intake. Diarrhea severe cases can be used intravenous high nutrition therapy.
Second, drug treatment: 1, astringent and antispasmodic: available top tomato combination, compound camphor tincture, pomegranate peel decoction (pomegranate peel 30g with water 200-300ml decoction of 50ml, once a day orally). Aspirin can effectively control the early diarrhea of radiation enteritis, which may be related to the inhibition of prostaglandin synthesis.
2, local analgesics and stool softeners: those with significant post-rash and pain can use 2% benzocaine cottonseed oil retention enemas. Use warm paraffin oil retention enema or warm water sitz bath.
3.Hormone enema: Succinyl hydrocortisone 50mg plus 200ml warm saline retention enema, especially effective for those with post-acute pain.
4.Presacral closure therapy: 0.5% procaine 40ml, vitamin B6100mg, vitamin B1200mg, α-chymotrypsin 2~5mg, streptomycin 0.5g, closed once every 5~7 days, treatment 1~3 times, can make pain significantly reduced.
5, hemostasis: low intestinal bleeding can be hemostatic under direct endoscopic pressure or use hemostatic agents or bleeding points for “8” suture hemostasis. However, cautery can not be used to stop the sedan. Higher bleeding points can be made with norepinephrine 4-6mg or 10-20mg diluted in 200ml of warm saline to retain the enema, or 100-1000 units of thrombin plus 200ml of warm saline to retain the enema, generally within 1 to 3 minutes to stop bleeding. Large amounts of uncontrollable high bleeding need to be surgical treatment.
6.Anti-infection: antibiotics are needed when there is secondary infection.
7.α2 macroglobulin: α2 macroglobulin has been tried in China for the treatment of radiation enteritis, with good results. 6ml of α2 macroglobulin is injected into the muscle every other day or 3ml is injected into the muscle every day, and the technique is 1 course of treatment for 2 months. The mucosal bleeding and pain improved significantly after the administration of the drug. The ulcer tended to heal. The principle may be by making plasma kinin-releasing enzyme, so that it is reduced, thus reducing capillary exudation and pain. At the same time α2 macroglobulin can combine with a variety of protein hydrolases to inhibit the action of the latter on the intestinal wall.
Third, surgical treatment: intestinal stenosis, obstruction, fistula and other late lesions mostly require surgical treatment. The distal colon lesion, transverse colostomy can be made to achieve permanent or temporary stool diversion, the results are often better than simply incising the distal colon lesion. Generally, colostomy needs to be closed after 6 to 12 months or more, once the function of the colon is restored.