Diarrhea months after radiation

[JazzMan42]

Had 20 sessions of IMRT late October to early November, 2024. Started getting diarrhea in early 2025 that is still happening. Asked my RO if the radiation caused this delayed reaction and he didn't think so because it didn't happen during or immediately after radiation ended. I am not so sure as I did not change my diet or medications so the only possible trigger was the radiation. I am seeing my primary doctor in a week, but I am anxious to hear from my brothers here if they had a similar issue.

[Mike1971]

Hi JazzMan42,

I had radiation therapy in 2022 and I’ve had (and have) problems with diarreha on and off since.

[JazzMan42 in reply to Mike1971]

Do you take anything such as Imodium or Metamucil?

[Mike1971 in reply to JazzMan42]

Yes, I take daily imodiun which helps.

[DannyMan in reply to Mike1971]

Imodium stopped working - I was up,to about 20 per day. Tue psyllium is far superior. Imodium is like synthetic oxy. Not great for you.

[Aardvark4]

This should tell you

ascopubs.org/doi/10.1200/ED..., Strategies to Minimize Late Effects From Pelvic Radiotherapy, scroll down to 'gastrointestinal side effects'. See also this - ascopubs.org/doi/10.1200/ED..., Management of Long-Term Toxicity From Pelvic Radiation Therapy

Avoid wheat bran - irritable to colon, oats are soluble, much gentler.

[Ollie366]

I had 28 treatments that ended in early July 2024. I had diarrhea on and off after but it started getting worse at the beginning of 2025. My RO suggested taking Garden of Life Men's probiotic plus phsyium fiber every day - based on their extensive experience, they said it helped many patients deal with the radiation induced diarrhea. I tried it and the first 2 weeks were tough but after that, it seems to be in control. BTW prior to my treatments I had IBS and even with that plus the radiation, I rarely have diarrhea. Might be worth a try

[DannyMan]

”Funny” - mine occurred in the middle of about 40 sessions - and I was told it would occur later, so it was not from the radiation.

Went to a gastro and he was totally confident it was from the radiation. I totally agree with that.

It lasted about 6 weeks. I lost a huge amount of weight. Horrible.

But it eventually went away.

Tip: the only thing I found that worked for longer duration was the psyllium (“Metamucil”). It’s not a drug and you basically take a bunch before eating and drinking and it creates a viscous “block” to slow it down.

Mine was awful - literally goin 50-100 times, bleeding, etc.

I’m a little nervous it could come back…

[UniversityGuy]

I have experienced this since spring 2023. Very helpful article from ASCO! Prostatectomy at age 44 in 2007; 40 days radiation and ADT in 2017, then a second recurrence in 2023 with PCa found in my presacral lymph nodes. Another 28 days radiation and ADT. Good news is that my PSA has been <0.01 for well over a year, and that's never happened. Bad news is that I do have proctitis, more urinary urgency and frequency, and my ED got worse (if that was even possible!). I'm alive at age 61, ostensibly cancer free for now, but I experience sadness/grief/anger at what this third round did to my sense of self.

[dhccpa]

No, though I had four mini-bouts of diarrhea during the 40 days of IMRT.

Beginning a week after finishing, I had skin sensitivity in rectal area that caused a painful scraping when stools initially exited. Also same issue in belly button. That issue is still receding almost three months later, especially in navel.

Also energy crashes, which came and went during radiation, still come and go, over and above what I've experienced during 6.5 years of continuous Lupron.

[UWDOG]

Yes, 8 weeks out from Proton mine started. No problems during treatment. I am now 12 weeks out, once a week I have a bad episode.

[UWDOG]

Jazzman, did you have Spaceoar? Were you at a center of excellence?

[JazzMan42 in reply to UWDOG]

UWDOG, no spacer because RO did not think it necessary, and not at Center of Excellence but at new cancer facility in Southern Oregon.

[UWDOG in reply to JazzMan42]

I had Spaceoar but it appeared misplaced, about half my prostate was covered. I think that is the reason I have a problem, although once a week is better than some.

[ron_bucher]

My GI doc recommended Citrucel.

[KenJamgo]

Yup same story for me... also did daily for both November/December 28 sessions and was having solid movements prior. Post radiation was your same story daily. No fun but I'm just living with it for now and docs say it should improve with time which is has slowly. My wife suggested remedies for immediate results which I declined as I prefer trying first to recover without pills and powders. If you have to be in 100% control and still work such that it would compromise your daily routine then jump on the quick fix train. Hopefully soon you'll have good news on your bowel movement improving.

[John778]

Underwent 25 radiotherapy treatments ending on July 3rd 2024. Since then I've had urgency, with frequent unformed stools (6-10 times a day). I take Metamucil twice a day & it helps firm things up but doesn't reduce the frequency. Steroid suppositories have reduced the irritation. Good luck on dealing with this unpleasant quality of life issue.

[northshoreguy]

I got radiation induced lactose intolerance, once I cut products with lactose, I cleared up

[Rbee]

After finishing thirty six radiation sessions in 2021, I had diarrhea/rectal incontinence problems continuously, for years. Fourteen months ago I went to a specialist and he got me on sucralfate enemas and anucort suppositories and the results have been excellent. Immodium use has gone from near daily to once or twice per month.

[UWDOG in reply to Rbee]

Do you continue to use the products or did you just need a course of them. ?

[Rbee in reply to UWDOG]

I did the sucralfate daily to start, and the anucort 1-2 x per week. I still use them, but as needed when symptoms return. So now it is sucralfate once per week or less, and anucort every ten days, or even less frequently. The constant concern and anxiety of incontinence has left my thoughts.

[chaddfgc]

Just the opposite for me after 2 SBRT blasts followed by 25 IMRT radiations I've been fighting constipation with the only remedy so far being prune juice. Hang in there bro.

[pj1121]

I got radiation proctitis and 6 months after 28 imrt. I have read it is common to have issues such as this and that within this timeline

[Pjford]

had 28 IMRT July 2024 , getting up 3 to 4 time a night . If I drink alcohol, I better be close to bathroom , cause can’t hold it like before