Abstract

Introduction: Proctitis is a troublesome complication in patients receiving radiotherapy in pelvic malignancies. This is a prospective study done to evaluate the efficacy of 4% formalin in treatment of radiation proctitis and complications associated with it.

Method: Patients with rectal bleeding post radiotherapy for gynaecological malignancy were analysed in our institution from June 2010-May 2011. 50ml of 4% formalin was sprayed through colonoscopy with mucosal contact time of 10 min and observed for 4hrs for any complication

Results: A total of 22 patients with mean age 57 (range 40-65) years, moderately built with radiation proctitis were subjected to 4% formalin and followed up for 12 (range 1-36) months. Mean interval between radiotherapy and presenting symptoms was 15 (range 6 -24) months. Cessation of bleeding occurred in 77.27% cases after mean of 2(range 1-4) cycles of spray with hemoglobin rise of 2gm% (range 1.1-2.9). 5 patients complained of intense pain relieved with analgesics and one had seizure. There was only one mortality in a patient who got operated for recto-vaginal fistula and expired on 5th post-operative day due to septicemia.

Conclusion: 4% formalin application is a simple, cost-effective, and well-tolerated method of controlling hemorrhagic radiation proctitis with less complications. It can be effectively used in settings with limited resources.