Rectal Bleeding 7 Months After Salvage Pelvic Radiation

[Polaris1]

I was shocked today to suddenly find a lot of blood and clots coming out of my rectum. This never happened before. But I see some information online that this can occur months, even years, after pelvic radiation. I had RP October 2018. I finished 38 radiation sessions October 2019 with virtually no side effects and undetectable PSA. Have others experienced this, and what was done to deal with this problem? (I had a colonoscopy April 2018 and told to have a re-check in 5 years.) Thanks in advance.

[Tall_Allen]

It is expected and not a big deal - although blood is scary -as long as the blood is bright red and not copious. If it is black and tarry or bleeds profusely, tell your doctor. The radiation weakens the walls of small blood vessels and hemorrhoids that can break easily. It usually goes away on its own. Don't be in a rush to have another colonoscopy or stick any kind of instrumentation up there. The radiation makes the rectal lining fragile and easily broken by sticking something up there. Consider a stool softener for a while to prevent damage.

[Polaris1 in reply to Tall_Allen]

Tall_Allen, thanks much for your prompt answer. Yes, it was bright red. I will be monitoring this closely. Thanks for the advice to be very cautious about damaging the fragile rectal lining.

[davebakerpurton in reply to Polaris1]

Try psyillium husk powder, 2 tsp in water once a day, eases the stool out, it works very well. Amazon sell it and have quite a bit of information about it.

[Polaris1 in reply to davebakerpurton]

Thanks for the tip. I have had some very hard stools in the past but not recently when the bleeding showed up.

[Ben2]

My bleeding started 6 months after radiation. Worsened over a year, then gradually improved for a year and has been non-existent since. Colonoscopy revealed damage to colon, but MD said wait rather than use possible treatments because of side effects.

[Polaris1 in reply to Ben2]

Ben2, thanks for sharing your experience. It's good to hear that, in your case, the bleeding stopped without treatment.

[Hidden]

It was stories like this that scared me away from radiation and towards HIFU. I hope things resolve for you without further intervention. I recall having some dire episodes of blood in my urine that were quite scary so I know the feeling.

[Polaris1 in reply to Hidden]

Thanks for your comment. I had virtually no side effects from the radiation, including no fatigue (age 72). I hope this bleeding problem resolves itself.

[MGuzzi]

I had a similar issues after radiation treatment. In my case it was diagnosed as radiation proctitis. It showed up long after my treatment, a delayed reaction. A colonoscopy showed there had been some light burn damage to the lining of my colon, according to the gastroenterologist. She was not that concerned and said bright red blood was not worrisome as long as it was in small amounts. I had been taking low dose aspirin and the bleeding went way down after I stopped. As Tall Allen says it is startling but not usually cause for concern. I also noticed a change of diet -- more fruit, etc -- seemed to help, natural stool softener.

[Polaris1 in reply to MGuzzi]

MGuzzi, thanks very much for sharing your experience with this problem. I have now exchanged emails with my radiation oncologist, and he recommended I stop taking the low dose aspirin. He thinks if the bleeding "recurs to any meaningful amount", he would refer me for a scope to see what caused the bleed, and if from radiation, it can be treated with laser therapy.

The bleeding (bright red) has continued in small amounts. Based on what you and Tall_Allen and Ben2 have written, I am inclined to soften my stools, monitor the situation, and not rush into a colonoscopy.