I completed salvage radiation around a year and 3 months ago. Since then I’ve had issues with my gut, specifically cramps in the morning and irregularity. This week I had a routine colonoscopy and asked the doc to advise whether he could see any damage resulting from radiation. He advised that I have mild proctitis with some rectal fibrosis.
I have read that damage from radiation can continue and/or show up many years after radiation. Has anyone else been diagnosed with proctitis following salvage radiation, and what was your experience? I’ve read that the sooner one gets on top of the issue, the better. Have you been provided with any sort of treatment? Is it ever too soon for treatment? Should I expect this to worsen over time?
Thanks in advance for any feedback.
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3 months was probably too soon for a colonoscopy - instrumentation can damage friable tissues. It sounds like the proctitis is minimal. I advise leaving it alone (Anusol with cortisone if you have tenesmus) and letting it heal on its own.
Hi Allen. Thank you so much for your response! I had my first colonoscopy around 3 months after radiation was completed. I specifically asked how long before I should wait to do the colonoscopy (was already beyond the 5 year recommendation, but delayed due to pandemic) and the radiation oncologist said 3 months was sufficient. Thankfully, there was no bleeding during that colonoscopy. However, that 1st colonoscopy failed due to “inadequate prep.” That prep was the same as I always do, so I thought maybe the issue was radiation injury related. My recent colonoscopy was a follow up to the failed one, so it was 1 year and 3 months following the completion of salvage radiation, and almost 1year following the failed colonoscopy. I’ve read that at the first sign of proctitis, treatment should be initiated. Are you thinking that given my current condition is tolerable and there is no bleeding, I should leave well enough alone? Should I assume my condition will deteriorate?
"I’ve read that at the first sign of proctitis, treatment should be initiated...Should I assume my condition will deteriorate?" This is counter to everything I've read. Do you have a reference?
Sorry, I don’t. I try to stick with whatever my Google search returns that is reasonably recent. Much of my conclusions are from piecing together information learned from multiple sources. I know that radiation can cause problems many years after the actual therapy… I’ve actually read up to 30 years. And I’ve read some horror stories about proctitis and how severe cases can led to a colostomy. Pretty scary stuff and I’m trying to stay a step ahead.
I stay pretty current on this. No need to upset yourself over 1 in a million events.
Thank you. I know you’re very well informed and I value your feedback.