The metabolic effects of abdominal irradiation in man with and without dietary therapy with an elemental diet

Foster, K. J.; Brown, Mark S.; Alberti, K. G. M. M.; Buchanan, R. B.; Dewar, P. J.; Karran, S. J.; Price, C P; Wood, Peter

doi:10.1016/s0009-9260(80)80073-0

Cited by 22 publications

(31 citation statements)

References 15 publications

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“…However, methodology was often weak, with reporting of method of randomisation, concealment of allocation and blinding lacking from many papers (Brown et al, 1980;Foster et al, 1980;Kinsella et al, 1981;Moriarty et al, 1981;Stryker and Bartholomew, 1986;Salminen et al, 1988;Karlson et al, 1989;Bye et al, 1992;Chowdhury et al, 2002;Delia et al, 2002). The choice of randomisation in papers that reported their methodology was adequate in two studies (Urbancsek et al, 2001;Martin et al, 2002).…”

Section: Methodological Quality Of Trialsmentioning

confidence: 99%

“…Probiotic supplementation in sachet or fermented yogurt presentation and modified food intake compared with modified food intake alone (Salminen et al, 1988;Delia et al, 2002). Elemental diet as a supplement to modified food intake or as a sole source of nutritional intake compared to modified diet or total parenteral nutrition (Brown et al, 1980;Foster et al, 1980;McArdle et al, 1986;Craighead and Young, 1998;Capirci and Polico, 2000). Enteral and parenteral protein-calorie nutrition support (Valerio et al, 1978;Kinsella et al, 1981;Moriarty et al, 1981;Macia et al, 1991;McCarthy and Weihofen, 1999;Chowdhury et al, 2002).…”

Section: Nutritional Interventionsmentioning

confidence: 99%

“…In addition, one of the studies (Salminen et al, 1988) also restricted fibre, fat and obvious sources of lactose in all patients. Five studies (including 847 patients), of which four were randomised controlled trials (Brown et al, 1980;Foster et al, 1980;McArdle et al, 1986;Capirci and Polico, 2000) and one was a phase II pilot study (Craighead and Young, 1998), investigated the use of elemental diet during pelvic radiotherapy. The type of elemental diet implemented varied between studies in terms of the specific product and the relative caloric contribution it provided.…”

Section: Nutritional Interventionsmentioning

confidence: 99%

“…No objective measures were described. Finally, one study (Brown et al, 1980) used an elemental-supplemented regimen, but failed to show any significant differences in bowel symptoms. Controls were asked to follow a low roughage diet, while the treatment group followed the same low roughage diet supplemented with three sachets of 'Vivonex HN elemental feed' providing 900 kcal.…”

Section: Nutritional Interventionsmentioning

confidence: 99%

“…A study comparing a low-fibre diet (specific content unknown) in controls, with the same diet alongside elemental supplementation (Foster et al, 1980), did not assess the effect of this intervention on gastrointestinal symptoms. Instead, haematological parameters and weight were compared.…”

Section: Nutritional Interventionsmentioning

confidence: 99%

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Role of nutritional intervention in patients treated with radiotherapy for pelvic malignancy

et al. 2004

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Up to 12 000 patients with gynaecological, urological and rectal cancer undergo radical pelvic radiotherapy annually in the UK. More than 70% develop acute inflammatory changes causing gastrointestinal symptoms during treatment because healthy bowel tissue is encompassed in the radiation field. In total, 50% go on to develop chronic bowel symptoms, which affect quality of life due to permanent changes in the small and large intestine. Nutritional intervention may influence acute and chronic bowel symptoms but the validity of the advice given to patients is not clear. To assess the incidence and significance of malnutrition and to examine the efficacy of therapeutic nutritional interventions used to manage gastrointestinal side effects in patients undergoing pelvic radiotherapy and those with chronic bowel side effects after treatment, a critical review of relevant original studies on human subjects was carried out using a specific set of mesh terms in MEDLINE and EMBASE databases and the Cochrane Library in September 2003. Full texts of all relevant articles were collected and reference lists were checked. Sources of grey literature including conference abstracts and webbased information were also reviewed. A total of 36 papers published in peer-reviewed journals between 1966 and 2003 were identified. In all, 14 randomised controlled trials, 12 prospective cohorts, four retrospective, two qualitative, one validation, one pilot study and two case reports were obtained. These included 2646 patients. Eight articles including three conference abstracts and webbased information were found. None of the studies was definitive because of weakness in methodology. No studies could be combined because the interventions and the end points were different. There is no evidence base for the use of nutritional interventions to prevent or manage bowel symptoms attributable to radiotherapy. Low-fat diets, probiotic supplementation and elemental diet merit further investigation.

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Section: Methodological Quality Of Trialsmentioning

confidence: 99%

Section: Nutritional Interventionsmentioning

confidence: 99%

Section: Nutritional Interventionsmentioning

confidence: 99%

Section: Nutritional Interventionsmentioning

confidence: 99%

Section: Nutritional Interventionsmentioning

confidence: 99%

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Role of nutritional intervention in patients treated with radiotherapy for pelvic malignancy

et al. 2004

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Nutritional interventions for reducing gastrointestinal toxicity in adults undergoing radical pelvic radiotherapy

Henson

Burden

Davidson

et al. 2013

Cochrane Database of Systematic Reviews

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Pathogenesis of acute radiation injury to the rectum

1994

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In a prospective investigation of the clinical and pathological effects of pelvic radiotherapy on the rectum, nine patients (age range 58-77 years) had symptoms assessed weekly during radical treatment for bladder and prostatic tumours, and at 2, 4 and 12 weeks after treatment. Stool frequency increased in all patients from a mean of 1.7 per day before treatment to 5.0 per day at 4 weeks (P < 0.05). Seven patients developed liquid stools during treatment; 6 had pain on defaecation, 8 had urgency of defaecation, all experienced tenesmus and 3 had episodes of faecal incontinence. One patient had symptoms of such severity that treatment was interrupted. Virtually all symptoms had resolved by 12 weeks after treatment. Sigmoidoscopy with biopsy of anterior and posterior rectal walls was performed before treatment began, at 2 weeks and 4 weeks during treatment, and 4 and 12 weeks after treatment. All patients during treatment had evidence of acute inflammatory damage with hyperaemic, oedematous mucosa and failure of healing of biopsy sites. Histological examination of the rectal biopsies revealed the well described characteristic mucosal changes with crypt cell damage, inflammatory cell infiltrate and loss of crypts. In 2 of 7 cases studied, pathology was still abnormal at 3 months. Radiation injury to bowel is an underemphasised cause of morbidity and further prospective studies are required to determine methods of reducing normal tissue damage and ameliorating symptoms.

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The metabolic effects of abdominal irradiation in man with and without dietary therapy with an elemental diet

Cited by 22 publications

References 15 publications

Role of nutritional intervention in patients treated with radiotherapy for pelvic malignancy

Role of nutritional intervention in patients treated with radiotherapy for pelvic malignancy

Nutritional interventions for reducing gastrointestinal toxicity in adults undergoing radical pelvic radiotherapy

Pathogenesis of acute radiation injury to the rectum

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