What approach have you found works best in treating persistent acute radiation proctitis in patients undergoing pelvic EBRT?

Obviously, this is an important question, though I'm a little unclear on the meaning of "persistent acute" radiation proctitis. Though I am not certain, I believe @Dr. First Last's answer applies more to chronic (or at least sub-acute) radiation proctitis. As for the more traditionally "acute" radia...

Persistent radiation proctitis results from epithelial atrophy and fibrosis associated with endarteritis and chronic mucosal ischemia. We have used Sucralfate enemas for these cases with good results. We generally avoid any steroid preparations, the logic being it can impact healing. If bleeding per...