Treatment of a radiogenic enterocolitis case using morphine

Regional radiotherapy is associated with considerable morbidity and mortality because of radiation delivered to adjacent healthy organs. One serious gastrointestinal adverse effect is radiogenic enterocolitis, which can appear after starting regional radiotherapy and produces diarrhoea with no effective treatment. We present the case of a woman with a rectosigmoid adenocarcinoma treated with different surgeries and radiation therapies. She got radiogenic enterocolitis treated with oral ethyl morphine during 30 years. In 2010, this drug was withdrawn and the patient consented to off-label treatment with oral immediate-release morphine chlorhydrate. The starting dose was low and increased progressively every two weeks. From April 2012 until April 2013, the dose remained between 20 to 30 mg per day according to the constipation. The patient had good response and tolerance with no side effects. This case report shows steady efficacy in an off-label treatment with oral immediate-release morphine chlorhydrate in radiogenic enterocolitis