Bowel issues after radiation

If you haven’t or don’t want to see a gastroenterologist (unless you already did with the colonoscopy to rule out other conditions?), then a few other non-medication interventions that are evidenced-based that I tried were: pelvic physical therapy, seeing a GI dietician, and working with a GI psychologist (they’re difficult to find, but you can also find books about mind-body interventions to address the brain/gut connection and improve symptoms).

I wasn’t aware, but pelvic PTs have a lot of knowledge about bowel issues and can especially help with constipation.

I take Sunfiber (the generic I take is by Heathy Origins), which has been shown to help both constipation and diarrhea and it’s well tolerated with IBS. It dissolves in liquid and has no taste.

However, I haven’t had radiation. I do struggle with constipation and less commonly, diarrhea.

I have attached a journal article that addresses the effects of radiation therapy on the gut micrbiome. You may want to have your stool checked for not only pathogens, but also to see the profile of existing beneficial bacteria. I went through bouts of diarrhea for years after taking a strong antibiotic. It took about 6 months of probiotics and fiber to help. Prior to that, Immodium was my best friend. Radiation induced intestinal injury should be addressed as a part of any treatment protocol. Best wishes for your recovery.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9824372/#:~:text=As%20one%20of%20these%20many,

I had problems after my radiation also, I now have proctitus from the radiation on and on. My husband and i are now eating 4 prunes a day and I take a stool softener these seem to help.

I've had a similar problems to Champs due to heavy pelvic radiation more than 34 years ago. My problems have ranged from intestinal blockages to diarrhea and as of this past February, I now have FECAL INCONTINENCE (a true nightmare).
Over the years, I have continued to try to find ways to help myself (e.g., alternative doctors, exercise, counselling, stool tests, special diets, supplements, googling for latest studies/info, etc). I expect I must continue to investigate and try new ways to help myself for the rest of my life (I am 77.)
I just learned about PELVIC FLOOR THERAPY. Maybe, I needed this for many years? Maybe this will be an answer? Maybe it won't help? Its worth a try.
No doctor has ever mentioned pelvic floor therapy to me before --- in fact, I never heard or read about it before other than for women who have had children. Thanks to a nurse practitioner (who didn't just think I was lucky to still be alive), Pelvic Floor Therapy was suggested for my FECAL INCONTINENCE and gave me a script so that the therpay is covered via my health insurance plan. I've had around 4 sessions with many more yet to come. I am hopeful (as usual) but the availability of certified pelvic floor therapist is very limited and getting an appointment has been difficult.
Pelvic Floor Therapy may benefit BOTH men and women for incontinence --- be it urinary, fecal or both. Few wish to talk about these problems.
I would like to hear from others about how they are trying to help themselves their long term effects of pelvic radiation/radiotherapy experienced 20 or more years ago and from those with fecal incontinence or other intestinal problems that are limiting their life,
Thank you!

Hi Michey, sorry you are experiencing the same issues! I hope that the pelvic floor therapy works for you! Please keep us posted on that! I have recently added probiotics to my diet (again) and am seeing some relief this time (so far at least). I have also added chia seeds to my smoothie after work out. The last few weeks have been better than the last few years have been. It's not perfect but is much better. I may speak to my doctor about PFT.

Champ, I'll report back in mid-August. My therapist is going on a July vacation so I am wait listed for Pelvic Floor Therapy. (I am limiting the PFT to only external mode and I can explain some other time if you are interested.)
This may be more than you and others wish to know (such an ugly subject):
Since April, I've been on a FODMAP diet and taking VISBIOME probiotic with breakfast and dinner. I think this has helped since I have less colicky pain and less frequent urgent BMs.
Now I have around 3 BMs per day with one usually being urgent and unpredictable. They are usually formed but quite pasty and terrible to remove the residue. A squirt bottle, sitz bath or wet cloths must be used.
I am just started using a sitz bath from 1-3 times daily for a hemorroid that was probably caused by going so much since February 2024. (But, now I question if the hemorroid is causing the leakage or if the leakage is causing the hemorroid!)
The gastro I saw in April was not helpful. His attitude was that it was probably muscle or nerve damage from the radiation 34 years ago. As I have sensed from some doctors in the past (but hopefully isn't true), he may have thought I should just be happy I am alive, anything wrong with me can be cancer, ---- with some ageism thrown on top.
I am moving on by seeking a new gastro next week who is female (my gastro of 30 years passed away suddenly --- so sad). The wait list to see any female gastro and proctologist is months here (NJ). I have several booked in September/October who I will see until I find the right one for me.
Almost every day, there is BM leakage. Lifting and exercise may bring them on but sometimes they just happen.
I put Trader Joe's ground Flax seed in my oatmeal. I can't seem to figure out if I need more fiber or less fiber so I experiment and track my diet and reactions in a diary.
I have chia seeds but I am trying them cautiously since they may bring back my intestinal blockages. (The blockages stopped with the fecal incontinence.)
Good for you that your past few weeks have been better for you! Thank you for your comments!