A Case Report of Radiation Proctitis Treated with Shiunko Enema

Fumio Ayukawa; Ayae Kanemoto; Yasuo Matsumoto; Tadashi Sugita; Akira Kikuchi; Kazuhiko Shioji; Takao Sunaga

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A Case Report of Radiation Proctitis Treated with Shiunko Enema

VernacularTitle:放射線直腸炎に対する紫雲膏注腸を用いた漢方治療の1例
Author: Fumio AYUKAWA ¹ ; Ayae KANEMOTO ¹ ; Yasuo MATSUMOTO ¹ ; Tadashi SUGITA ¹ ; Akira KIKUCHI ² ; Kazuhiko SHIOJI ³ ; Takao SUNAGA ⁴
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1. Niigata Cancer Center Hospital, Department of Radiotherapy
2. Niigata Cancer Center Hospital, Department of Gynecology
3. Niigata Cancer Center Hospital, Department of Internal Medicine
4. Niigata Medical-Care Cooperative, Kido Clinic
Keywords: shiunko; radiation proctitis; rectal ulcer; Kampo
From:Kampo Medicine 2020;71(4):371-377
CountryJapan
Language:Japanese
Abstract: We report a case of a 57-year-old woman with radiation proctitis (RP) treated by shiunko (SK) enema with promising outcomes. The patient underwent interstitial brachytherapy for anterior vaginal vault recurrence of uterine cancer. Nine months after the treatment, she had anal pain and was diagnosed with RP by clinical course and colonoscopy. The rectal ulcer was so severe that a surgeon proposed permanent stoma formation as one option, given eventual risk of rectovaginal fistula. The patient rejected stoma formation and opted for Kampo medicine. Though she took keishibukuryogankayokuinin for blood stasis at first, her anal pain and rectal bleeding gradually worsened. Thereafter, she mainly used SK enema, kyukikyogaito and magnesium oxide. Anal pain and rectal bleeding decreased after applying SK to the rectal wall per rectum. Magnetic resonance imaging (MRI) and colonoscopy findings of the rectal ulcer also improved. SK effectively reduced anal pain and rectal bleeding as well as stimulated tissue repair in our patient, and therefore SK is worth considering in the treatment of RP.