radiation proctitis

[Jmr11820]

I am almost 3 years out from radiation therapy and I’m still suffering from symptoms of radiation proctitis. I did have it confirmed by colonoscopy about a year and a half ago, at that time the gastroenterologist told me he thought it would resolve eventually but it persists. Have any of you had G.I. symptoms as a result of radiation therapy several years out from the end of your treatment?

[Tall_Allen]

Have you tried hyperbaric oxygen therapy?

[Jmr11820 in reply to Tall_Allen]

no, but I have an appointment Monday with my gi doc and will ask . Thanks Allen.

[DJBUNK]

I had radiation proctitis starting about 8 months after the end of my radiation treatments. That was around the beginning of 2021. I had some bleeding almost every week, often significant, for nearly 3 years. A colonoscopy 2 years after my treatments ended confirmed moderate damage. The GI doctor wanted to cauterize the damage but my radiation oncologist insisted that I not have any cauterization so I didn't have it done.

My oncologist prescribed Trental to increase blood flow in the area (to speed healing) twice a day for the past 2 years. About 2.5 years after it started, the bleeding was significantly reduced but still present. Somewhere along the way (about 2 years in), my cardiologist told me to start taking low dose aspirin. I felt like a dummy when my oncologist asked me at my last visit (3 months ago) why I was taking the aspirin. Since I don't really have any heart issues (just a precaution by my cardiologist) my oncologist told me to stop unless absolutely necessary. Almost immediately the bleeding stopped. I've only had one bleeding incident since then.

Obviously the aspirin was promoting bleeding once I started taking it, but the bleeding was present for nearly 2 years even before I started taking the aspirin.

My radiation oncologist told me that the colon heals more slowly than other body parts (like a cut in the skin) which is why he prescribed the Trental. It took nearly 3 years but my proctitis seems to be over for the most part although just this week I had noticable blood in my urine. Hopefully that doesn't become an issue.

I hope your condition resolves itself soon. If not maybe the hyperbaric treatments suggested by Tall Allen will do the trick.

[Jmr11820 in reply to DJBUNK]

thank you. I’ll mention that at my Monday appointment.

[Jmr11820 in reply to Jmr11820]

the Trental

[JRPnSD]

I had Radiation Proctitis diagnosed 24 months post my 38 sessions of salvage radiation (GL9, Stage 4 RP, ADT 18 months, Radiation). Went through the Argon laser treatment during a colonoscopy (which followed an inconclusive Sigmoidoscopy) - after evidence of anal bleeding. I was told this was unusual this late after...but happens. I also went through emergency surgery for an obstructed bowel last month (sm. intestine got trapped in a hernia that appeared after the Robotic RP surgery.) They told me it didn't need repair when found back in 2020 and that it wasn't an unusual development post-RP? I just keep advocating for myself...as the experts keep guessing. I am undetectable since 10/2020 after recurrence was detected 10 months post-RP, and started antagonist ADT then for 18 months. Now 16 months post end of ADT. Fingers crossed...lead a "normal" life. We need a decision tree with all possible detours listed for Advanced PC.......it is a MAZE. YOU are your best ADVOCATE!

[garyjp9 in reply to JRPnSD]

I also had a post-RP hernia. It is not so unusual but also not supposed to happen. I had my repaired soon because it was painful. Glad you are doing well now.

[Jmr11820]

Your argon treatment took care of bleeding, right?

[AgedTenor]

I had EBRT to the prostate bed in 2010 after RRP in 2009, unfortunately with little effect on my PSA. I have also had SBRT to three different metastases, including one course this year to T5. I have not had bleeding from the anus at any point but I do still get some bouts of wind combined with mucal discharge from time to time, alternating with constipation. I hope your condition soon improves.

[Cyclingrealtor]

Is this when many times you have a clear mucus when farting or pooping?

I have had those symptoms after radiation - clear mucus. During radiation I had told the RO that I was having significant diarrhea during radiation and his reply was that it was "just from your high fiber diet". While I eat mostly vegetarian and seafood, I wouldn't consider it a high fiber diet and loose stools and diarrhea were not normal.

After radiation I wouldn't be able to leave the house for about 3 - 4 hours after radiation because I would have really bad liquid diarrhea. Then it would become controllable and on the weekend I was fine.

Thoughts?

[Karmaji]

I had boost RT in nov 2019 on prostate and pelvis. Started having stool blood around DEC 2020.

Gradually it started to iincrease and mid 21 once a week then every day ...red blood and no pain. Wanted to understand the mechanism of radiation damage to rectum cells. Consulted 4 top gastros in France, and they had no knowledge and had no interest in understanding how radiated cells keeps damaging other cells. All they said with a grimace, it will keep getting worse.

It is shocking to see complete ignorance about damage by radiated cells, so many men women get radiated by therapies every year. Nothing is published regarding non-invasive Chronic rectum radiation treatment... no money there.

Only 2 articles in 2000...Kochar et al using sucralfate enema 1999 and Kennedy et al using vitamins 2001 for CRP

Wrong suggestion to use Betnesol and Mesalazine. ... ignorance

All gastros wanted to APC.... very paying....I did not burn rectum layer...

On my own with no follow up by any gastro....

Thus I tried Sucralfate enema 2g/30 cl water twice a day for 5months.... from May 2022 til sep.80 % cured...then its use was irritating.....sure who wants to do enema twice a day for 5 months....

Then I switched to vitamin A 10000, C 500 mg, E 400 ( half dose of Kennedy et al.) in september 2022 and I am still following ..... 99 % cured...blood spots once every 10 to 14 days...

My RO says maybe I should stop to see if it cures by itself. My interest is to heal the radiated cells activities for which vitamin A,C,E are useful... Why no RO, Gastro talks.....

I hope it may be useful to my tribe members.....patient power...as new generation docs say cure is 80 % in patient hand and 20 % in docs hand who simply follow the protocols...

[Jmr11820 in reply to Karmaji]

what are you referring to (half dose of Kennedy et al.)?

[Jmr11820]

so if you were to start all over again after radiation, trying to treat this issue, you would use your vitamin protocol, correct? How long was it before you saw results after starting vitamins in September

[SallyJones]

My husband's lab results show some blood in his urine, but nothing otherwise visible or remarkeable as per the MD. He is still on Lupron but finished his radiation tx for prostate cancer about 1 year ago now. Don't know if this helps but hope it gets resolved.

[Jimbo59]

Still have occasional blood while empting bowels, nearly 8 years after hypofractionated aRT in 2015. Also some mucus at times. However not in sufficient quantity to cause any real issues. Bowel and urinary urgency remain a bigger issue to me. Did have some hyperbaric sessions about 5 years ago but didn't see any obvious improvement at the time. Not sure if this helps you.

[Jmr11820 in reply to Jimbo59]

just makes me feel a little reassured. does your doctor simply tell you not to worry as long as blood loss is minimal?

[Jimbo59]

Thats about right. Doesnt seem to be any need for, or treatment available or offered for occasional minor loss. Only once has blood got to the level where it caused a bit of staining to underclothes. No need to wear red trousers thankfully!

[Jmr11820 in reply to Jimbo59]

last question. This is a regular occurrence for me. Probably half the time I go. But, not lots of blood loss. How frequently are you affected?

[Jimbo59]

A lot less than 50%. Maybe 5% or so.Sometimes a gap of a month or two so no clear pattern. Just put it down to random rupturing of radiation affected blood vessels in colon. Always short term.