Kennedy, M., Bruninga, K., Mutlu, E.A., Losurdo, J., Choudhary, S., & Keshavarzian, A. (2001). Successful and sustained treatment of chronic radiation proctitis with antioxidant vitamins E and C. American Journal of Gastroenterology, 96(4), 1080–1084.

To determine whether antioxidant vitamins, by counteracting oxygen-free radical injury, would relieve symptoms of chronic radiation proctitis

Patients received 400 IU vitamin E and 500 mg vitamin C three times per day for eight weeks.

• This study reported on 20 consecutive patients (10 prostate cancer survivors and 10 gynecologic cancer survivors) from a single gastroenterology clinic. 
• Patients were experiencing persistent, postradiation proctitis with disabling diarrhea, urgency, or fecal incontinence.

This study used a nonrandomized, before-and-after design in which patients served as their own controls.

Patients completed questionnaires that assessed severity, frequency, and lifestyle impact of four factors (rectal bleeding, rectal pain, diarrhea, and fecal urgency) with each factor rated on a five point, Likert-type scale ranging from 0–4.

The majority of patients (14 out of 16) reported less diarrhea, and eight said diarrhea stopped completely. Among patients with rectal bleeding or urgency, symptoms completely resolved in 36% and 19%, respectively. Lifestyle improved in 13 patients, and seven reported a return to normal.

The study is limited because it is nonrandomized and noncontrolled, involves a single clinic, and has a small sample size.

The use of vitamins E and C to manage radiation-induced diarrhea symptoms represents a low risk of harm.