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Journal of Medical Case Reports

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Open Access 01-12-2024 | Metformin | Case report

Chronic radiation proctitis refractory to steroid enema was successfully treated by metformin and sodium butyrate: a case report

Authors: Mau-Shin Chi, Ping-Hsun Hsieh, Shu-Han Huang, Ho-Chi Hsu, Kwan-Hwa Chi

Published in: Journal of Medical Case Reports | Issue 1/2024

Abstract

Background

Radiation proctitis (RP) is a significant complication of pelvic radiation. Effective treatments for chronic RP are currently lacking. We report a case where chronic RP was successfully managed by metformin and butyrate (M-B) enema and suppository therapy.

Case presentation

A 70-year-old Asian male was diagnosed with prostate cancer of bilateral lobes, underwent definitive radiotherapy to the prostate of 76 Gy in 38 fractions and six months of androgen deprivation therapy. Despite a stable PSA nadir of 0.2 ng/mL for 10 months post-radiotherapy, he developed intermittent rectal bleeding, and was diagnosed as chronic RP. Symptoms persisted despite two months of oral mesalamine, mesalamine enema and hydrocortisone enema treatment. Transition to daily 2% metformin and butyrate (M-B) enema for one week led to significant improvement, followed by maintenance therapy with daily 2.0% M-B suppository for three weeks, resulting in continued reduction of rectal bleeding. Endoscopic examination and biopsy demonstrated a good therapeutic effect.

Conclusions

M-B enema and suppository may be an effective treatment for chronic RP.

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Title: Chronic radiation proctitis refractory to steroid enema was successfully treated by metformin and sodium butyrate: a case report
Authors: Mau-Shin Chi
Ping-Hsun Hsieh
Shu-Han Huang
Ho-Chi Hsu
Kwan-Hwa Chi
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Metformin
Proctitis
Radiotherapy
Published in: Journal of Medical Case Reports / Issue 1/2024
Electronic ISSN: 1752-1947
DOI: https://doi.org/10.1186/s13256-024-04551-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Chronic radiation proctitis refractory to steroid enema was successfully treated by metformin and sodium butyrate: a case report

Abstract

Background

Case presentation

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Case presentation

Conclusions

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