Formalin application is effective for the treatment of Hemorrhagic Proctitis caused by radiation therapy

Objective: Radiation proctitis is a serious complication due to pelvic radiotherapy after pelvic malignancies. The aim of this study was to evaluate the efficacy of 4% formalin solution enema application in hemorrhagic proctitis caused by radiation therapy. Methodology: From February 2008 to February 2009, 13 patients with hemorrhagic radiation induced proctitis were treated in our clinic with 4% formaldehyde solution enema application. They were followed up to six months after the treatment. Results: In all cases, bleeding ceased after the first application. One of the patients experienced re-bleeding three weeks after the formalin application, and repeated formalin enema application controlled the bleeding. Follow up evaluation at sixth month showed no signs of acute proctitis or rebleeding. Two patients suffered from perianal pain during the first two months after the formalin application, however symptoms improved after that. Conclusion: 4% formaldehyde solution application for treatment of hemorrhagic radiation induced proctitis, can be performed easily and is a well tolerated technique with good long term results.