Acute Gastro-Intestinal Radiation Syndrome, Radiation,

1. Dmitri Popov. PhD, Radiobiology. MD
(Russia)
Advanced Medical Technology and
Systems Inc. Canada.
Acute Radiation Gastro-Intestinal
Syndrome.

2. Acute Gastro-Intestinal Radiation Syndrome.

3. Acute Gastro-Intestinal Radiation Syndrome.

4. Acute Gastro-Intestinal Radiation Syndrome.

5. Acute Gastro-Intestinal Radiation Syndrome.

6. Acute Gastro-Intestinal Radiation Syndrome.

7. Acute Gastro-Intestinal Radiation Syndrome.

8. Acute Gastro-Intestinal Radiation
Syndrome.
 Grading System for Acute Gastro - Intestinal
Radiation Syndrome based on general clinical
signs .
 Degree 1 – Mild GI ARS.
 Radiation GI Neurotoxins - SRD – 3.1. – Group.
Nausea, Vomiting - Occasional (once per day).
Anorexia - Able to eat , appetite decreased.
Fatigue syndrome - Able to work.
Hypotension - Blood pressure>100/70 mm Hg.

9. Acute Gastro-Intestinal Radiation
Syndrome.
 Colon Epithelium deficit – increased apoptosis,
focal necroptosis. Inflammation detectable, but
not significant.
 Blood loss - Detectable, minor.
 Degree 2 of GI ARS - Moderate degree.
 Group of Radiation Neurotoxins SRD – 3.2.
 Nausea, Vomiting – Intermitted (2-5 times per
day).
 Anorexia. Intake decreased.

10. Acute Gastro-Intestinal Radiation
Syndrome.
 Fatigue syndrome: Impaired work ability.
 Hypotension: Blood pressure <100/70 mmHg.
 Colon Epithelium deficit: Easy detectable.
Increased apoptosis, significant necroptosis.
 Blood loss - Moderate loss.
 Degree 3 – Severe degree of GI ARS.
 Radiation GI Neurotoxins: SRD – 3.3 Group.
 Nausea, Vomiting - Persistent (6-10 times per
day). Bloody diarrhea. Need assistance in activity
of daily living.

11. Acute Gastro-Intestinal Radiation
Syndrome.
 Anorexia: Intake minimal, Parenteral nutrition.
 Hypotension - Blood pressure <90/60 mm Hg.
 Need blood components transfusion.
 Major blood loss. Life treating.
 Colon Epithelium deficit – significant damage,
inflammation, necroptosis, some or significant
ulceration with colon wall damage.

12. Acute Gastro-Intestinal Radiation
Syndrome.
 Degree 4 – Extremely severe Grade of GI ARS.
 Radiation GI Neurotoxins: SRD – 3.1.
 Nausea, Vomiting: Extremely severe
 Refractory (>10 times per day)
 Anorexia: Parenteral nutrition.
 Fatigue syndrome: Severe fatique.
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13. Acute Gastro-Intestinal Radiation
Syndrome.
 Hypotension: Blood pressure <80/? Mm Hg;
Heart beat cessation. Life threatening,
 Colon Epithelium deficit: Prominent loss of colon
function with deep colon wall damage, epithelium
necroptosis, necrosis, severe form of ulceration.
 Possible perforation, function cessation.
 Major bleeding from GI tract.

14. Acute Gastro-Intestinal Radiation Syndrome.

15. Acute Gastro-Intestinal Radiation Syndrome.

16. Acute Gastro-Intestinal Radiation Syndrome.

17. Acute Gastro-Intestinal Radiation Syndrome.

18. Acute Gastro-Intestinal Radiation Syndrome.

19. Acute Gastro-Intestinal Radiation Syndrome.

20. Acute Gastro-Intestinal Radiation Syndrome.

21. Acute Gastro-Intestinal Radiation Syndrome.
 Gastrointestinal (GI) syndrome: the Acute
Gastrointestinal syndrome occur with a dose
greater than approximately 10 Gy (1000 rads)
although some symptoms may occur as low as 6
Gy or 600 rads.
 Survival rate depend on severity of GI - ARS.
Destructive and irreparable changes in the GI tract
usually cause infection, dehydration, and electrolyte
imbalance. Death usually occurs within 2 weeks.

22. Acute Gastro-Intestinal Radiation Syndrome.
 Gastrointestinal (GI) ARS usually develop
together with Hematopoietic ARS.
 Gastrointestinal (GI) - Symptoms are anorexia,
severe nausea, vomiting, cramps, and diarrhea.
• Onset occurs within a few hours after exposure.
• Stage lasts about 2 days.
 Hematopoietic ARS - Symptoms are anorexia,
nausea and vomiting.
• Onset occurs 1 hour to 2 days after exposure.
• Stage lasts for minutes to days.

23. Acute Gastro-Intestinal Radiation Syndrome.
 Hematopoetic ARS (developing together with GI
ARS)
 • Stem cells in bone marrow are dying, although
patient may appear and feel well.
• Stage lasts 1 to 6 weeks.
 GI ARS - Stem cells in bone marrow and cells
lining GI tract are dying, although patient may
appear and feel well. Stage lasts less than 1
week.

24. Acute Gastro-Intestinal Radiation Syndrome.
 Hematopoietic ARS - Symptoms are anorexia,
fever, and malaise. Drop in all blood cell counts
occurs for several weeks.
Primary cause of death is infection and
hemorrhage. Developing in together with GI –
ARS.

25. Acute Gastro-Intestinal Radiation Syndrome.
 GI - ARS Symptoms are malaise, anorexia,
severe diarrhea, fever, dehydration, and
electrolyte imbalance + symptoms of
Hematopoietic ARS.
Death is due to infection, dehydration, and
electrolyte imbalance.
Death occurs within 2 weeks of exposure.
 The extent of colonic mucosal involvement and
severity of disease correlate with the clinical
manifestations of ulcerative radiation colitis.

26. Acute Gastro-Intestinal Radiation Syndrome.
 Mild Grade of Gastro- Intestinal ARS.
 Death in 10 - 15 days

27. Acute Gastro-Intestinal Radiation Syndrome.
 Moderate Grade of Gastro- Intestinal ARS.
 Death in 5-7 days

28. Acute Gastro-Intestinal Radiation Syndrome.
 Severe Grade of Gastro- Intestinal ARS.
 Death in 2 - 3 days.

29. Acute Gastro-Intestinal Radiation Syndrome.
 Extremely Severe Grade of Gastro-Intestinal
ARS.
 Death in 24 hours.