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K52.0 – Radiation Colitis: Causes & Treatment
K52.0 is the ICD-10 code for radiation colitis and enterocolitis – inflammatory bowel conditions caused by ionising radiation during cancer treatment.
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K52.0 is the ICD-10 code for radiation colitis and enterocolitis – inflammatory bowel conditions caused by ionising radiation during cancer treatment.
What is K52.0?
The ICD-10 code K52.0 refers to radiation colitis and radiation enterocolitis – inflammatory conditions of the large and/or small intestine caused by exposure to ionising radiation. This condition occurs primarily as a side effect of radiation therapy (radiotherapy) used to treat cancers of the pelvis, abdomen, or retroperitoneal region.
Causes
The most common cause is therapeutic irradiation for malignant diseases, particularly:
- Prostate cancer
- Cervical and uterine cancer
- Rectal and colon cancer
- Bladder cancer
- Pelvic lymphomas
Radiation directly damages the sensitive mucosal cells lining the intestine and triggers an inflammatory response, as well as long-term changes to the vascular supply of the bowel tissue.
Symptoms
Symptoms can be divided into an acute and a chronic phase:
Acute Radiation Colitis (during or shortly after radiation therapy)
- Diarrhoea
- Abdominal cramps and pain
- Bloating and flatulence
- Blood or mucus in the stool
- Frequent urge to defecate (tenesmus)
- Nausea
Chronic Radiation Colitis (months to years after radiation therapy)
- Persistent diarrhoea or constipation
- Rectal bleeding
- Scarring and narrowing of the bowel (strictures)
- Fistula formation
- Malabsorption of nutrients
- Unintentional weight loss
Diagnosis
Diagnosis of radiation colitis is based on a combination of:
- Medical history: Prior radiation therapy to the abdomen or pelvic region
- Colonoscopy / Endoscopy: Assessment of the intestinal mucosa for signs of inflammation, erosions, ulcerations, or telangiectasias
- Imaging: CT or MRI to detect strictures, fistulas, or abscesses
- Histology: Tissue biopsy to differentiate from other bowel conditions
- Laboratory tests: Full blood count, inflammatory markers (CRP, ESR), albumin levels
Treatment
Treatment depends on the severity of the condition and whether it is acute or chronic:
Conservative Treatment
- Dietary measures: Low-fibre, easily digestible diet; parenteral nutrition if severe malabsorption occurs
- Antidiarrhoeal agents: e.g., loperamide for symptom control
- Topical or systemic corticosteroids: To reduce inflammation
- Sucralfate enemas: For rectal bleeding
- Hyperbaric oxygen therapy (HBOT): May promote tissue healing in chronic cases
Interventional and Surgical Treatment
- Endoscopic coagulation: For rectal bleeding caused by telangiectasias (e.g., argon plasma coagulation)
- Surgical intervention: For strictures, fistulas, or severe complications; may include stoma formation
Prognosis
Acute radiation colitis typically resolves after the completion of radiation therapy. However, the chronic form can be difficult to treat and requires long-term medical management. Regular follow-up examinations are important, as radiation-damaged tissue may carry an increased risk of secondary complications.
References
- World Health Organization (WHO): ICD-10 Classification of Diseases, K52.0 – Radiation gastroenteritis and colitis.
- Shadad AK et al. – Gastrointestinal radiation injury: Symptoms, risk factors and mechanisms. World J Gastroenterol. 2013; 19(2): 185–198.
- Stacey R, Green JT – Radiation-induced small bowel disease: latest developments and clinical guidance. Ther Adv Chronic Dis. 2014; 5(1): 15–29.
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