From the Research
After application of Purastat for radiation proctopathy, patients should typically remain nil by mouth (NPO) for 2 hours, as this allows the Purastat gel to properly adhere to the treated area and form a protective barrier over the damaged rectal tissue. Purastat is a synthetic peptide-based hemostatic gel that works by creating a scaffold at the application site, promoting tissue healing and preventing bleeding 1. The fasting period helps prevent displacement of the gel through digestive movements or food passage, maximizing its therapeutic effect.
Key Considerations
- The most recent and highest quality study on the use of Purastat for radiation proctopathy was published in 2021, which demonstrated the efficacy and safety of Purastat in reducing bleeding and improving endoscopic grade in patients with severe refractory radiation proctopathy 1.
- While there is limited evidence on the specific duration of NPO after Purastat application, a 2-hour fasting period is a reasonable recommendation based on the mechanism of action of the gel and the need to prevent displacement.
- Patients should be advised to avoid spicy foods, alcohol, and caffeine for 24-48 hours after the procedure, as these may irritate the treated area.
- Patients should also be advised to avoid straining during bowel movements for several days following the procedure to prevent disruption of the healing tissue.
Evidence Summary
- A 2021 study published in Frontline Gastroenterology demonstrated the efficacy and safety of Purastat in reducing bleeding and improving endoscopic grade in patients with severe refractory radiation proctopathy 1.
- A 2016 Cochrane review found that argon plasma coagulation and sucralfate enemas may be effective in reducing symptoms of radiation proctopathy, but the evidence was limited by the small number of studies and the variability in study design and outcomes 2.
- A 2012 systematic review found that endoscopic therapy with argon plasma coagulation may be effective in reducing short-term symptoms of chronic radiation proctopathy, but the evidence was limited by the small number of studies and the variability in study design and outcomes 3.