PWE-020 Endoscopically applied intra-rectal formalin for radiation proctopathy: short and longer term outcomes

Introduction Refractory rectal bleeding has been reported to occur in 2 to 51% of patients who previously received pelvic radiotherapy. It can significantly impair quality of life but there is no standard therapy for radiation induced rectal bleeding. Use of intra-rectal formalin has been described but there are no standardised protocols. Aim: To assess short and long-term outcomes prospectively after intra-rectal formalin delivered endoscopically in unsedated patients for radiation-induced rectal bleeding. Method Patients with significant rectal bleeding due to a radiation proctopathy were treated with instillation of 5% formalin into the rectum through a flexible endoscope for 3 min followed by irrigation. This was repeated every 6–8 weeks, if there was no response, up to a maximum of 4 times. Results Forty-three patients received intra-rectal formalin therapy: 14 (33%) required one session to alleviate bleeding; 17 (40%) required two; 10 (23%) received three; and 2 (4%) received four. Median follow up was 29 months (range 4–67). Using patient recorded outcome measures (PROM), there was a significant reduction in nuisance from rectal bleeding after treatment ( P Conclusion Administering intra-rectal formalin endoscopically is effective, safe, well tolerated, technically simple and can be done in an outpatient setting with few long-term complications. Disclosure of interest None Declared. Reference Gami B, Harrington K, Blake P, Dearnaley D, Tait D, Davies J, et al . How patients manage gastrointestinal symptoms after pelvic radiotherapy. Aliment Pharmacol Ther. 2003;18(10):987–94