Looking for tips on managing radiation-induced proctitis

Posted by rtv @rtv, Dec 17, 2023

Looking for tips from anyone who has experienced bowel incontinence caused by radiation induced proctitis. My husband was diagnosed with radiation induced proctitis 2 years post-radiation therapy. He had a bleeding rectal ulcer that was treated with twice daily sucralfate enemas for 8 weeks. The bleeding has stopped but he still has occasional fecal incontinence.

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Profile picture for vircet @vircet

@jc76 i completed my 5-treatment SBRT last Monday and noticed a little blood on toilet paper yesterday and this morning. I didn't have Space OAR; my oncologist said I didn't need it because I had gold seeds (fiducial markers) implanted on my prostate for MRI-Guided radiation planning. Your minor bleeding was several months after radiation stopped; did it get a little worse before it went away? My oncologist said my immediate side effects will peak 3 or 4 weeks after my last treatment. On my 4th week after last radiation, I will be on a cruise so I am a bit worried if my minor bleeding now will get much worse at that point.

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My husband's radiation proctitis developed approximately 2 years after he completed treatment. The bleeding got worse after he was treated by APC (argon plasma coagulation) during a routine colonoscopy. The APC caused a bleeding rectal ulcer and explosive diarrhea. We did twice a day medicated (sucralfate) enemas for about three months. The bleeding stopped almost immediately after starting the enemas but we had to keep treating until the ulcer had totally healed.

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SpaceOar barrier gel was placed January 2025 and I had 44 weekday IMRT treatments during February-April. Diarrhea started along the way and continued after treatment until December, when I started taking Psyllium fiber and probiotic daily. This took care of the diarrhea, but I continued having 4-6 bowel movements daily. In January, 2026 I was diagnosed with radiation proctitis during a colonoscopy and prescribed four weeks of twice-daily Sucralfate enemas which I will finish this week. Bleeding has stopped and BMs are down typically to four: three between 5-9 A.M. and one afternoon/evening. Any suggestions toward complete healing? I have read somewhere here on the forum that a patient took these enemas for a year and then had hyperbaric oxygen treatment. Your input to control my output is appreciated!

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Profile picture for jime51 @jime51

SpaceOar barrier gel was placed January 2025 and I had 44 weekday IMRT treatments during February-April. Diarrhea started along the way and continued after treatment until December, when I started taking Psyllium fiber and probiotic daily. This took care of the diarrhea, but I continued having 4-6 bowel movements daily. In January, 2026 I was diagnosed with radiation proctitis during a colonoscopy and prescribed four weeks of twice-daily Sucralfate enemas which I will finish this week. Bleeding has stopped and BMs are down typically to four: three between 5-9 A.M. and one afternoon/evening. Any suggestions toward complete healing? I have read somewhere here on the forum that a patient took these enemas for a year and then had hyperbaric oxygen treatment. Your input to control my output is appreciated!

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As I am going through similar radiation treatment, do you mind if I ask if you had a) fiducial markers and b) preexisting IBS, diabetes, uncontrolled HTN or other complicating factor? Best of luck on your treatment.

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Profile picture for jime51 @jime51

SpaceOar barrier gel was placed January 2025 and I had 44 weekday IMRT treatments during February-April. Diarrhea started along the way and continued after treatment until December, when I started taking Psyllium fiber and probiotic daily. This took care of the diarrhea, but I continued having 4-6 bowel movements daily. In January, 2026 I was diagnosed with radiation proctitis during a colonoscopy and prescribed four weeks of twice-daily Sucralfate enemas which I will finish this week. Bleeding has stopped and BMs are down typically to four: three between 5-9 A.M. and one afternoon/evening. Any suggestions toward complete healing? I have read somewhere here on the forum that a patient took these enemas for a year and then had hyperbaric oxygen treatment. Your input to control my output is appreciated!

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Sorry...I don't have any help for you but this...
"Your input to control my output is appreciated!"
...made me spit my coffee on my keyboard. 🤣🤣🤣

Best wishes!

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Profile picture for bob1955 @bob1955

As I am going through similar radiation treatment, do you mind if I ask if you had a) fiducial markers and b) preexisting IBS, diabetes, uncontrolled HTN or other complicating factor? Best of luck on your treatment.

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@bob1955 I do have two tiny first-ever tattoos on my abdomen, according to my wife. Each treatment consisted of careful placement, scan, and then radiation. I've never been diagnosed with IBS but tend toward bloating and gas. I am pre-diabetic and take Diltiazem to control BP. I'm 74.

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Profile picture for mjp0512 @mjp0512

Sorry...I don't have any help for you but this...
"Your input to control my output is appreciated!"
...made me spit my coffee on my keyboard. 🤣🤣🤣

Best wishes!

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@mjp0512 Maintaining some sort of humor, however twisted, is vital to getting through this stuff for all of us!

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Profile picture for jime51 @jime51

SpaceOar barrier gel was placed January 2025 and I had 44 weekday IMRT treatments during February-April. Diarrhea started along the way and continued after treatment until December, when I started taking Psyllium fiber and probiotic daily. This took care of the diarrhea, but I continued having 4-6 bowel movements daily. In January, 2026 I was diagnosed with radiation proctitis during a colonoscopy and prescribed four weeks of twice-daily Sucralfate enemas which I will finish this week. Bleeding has stopped and BMs are down typically to four: three between 5-9 A.M. and one afternoon/evening. Any suggestions toward complete healing? I have read somewhere here on the forum that a patient took these enemas for a year and then had hyperbaric oxygen treatment. Your input to control my output is appreciated!

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I have seen marked improvement using Mesalamine enemas for my proctitis over the past 9 days. I was up to 8-9 bm's per day prior. Now 1-2 per day without the urgency and rapid Penguin walk.

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Profile picture for chippydoo @chippydoo

I have seen marked improvement using Mesalamine enemas for my proctitis over the past 9 days. I was up to 8-9 bm's per day prior. Now 1-2 per day without the urgency and rapid Penguin walk.

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@chippydoo Thanks! You answered the question I asked you in another thread. I'll reach out to my GI.

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Profile picture for jime51 @jime51

@chippydoo Thanks! You answered the question I asked you in another thread. I'll reach out to my GI.

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@jime51, you may also want to review these related discussions about radiation-induced proctitis:

- Looking for tips on managing Radiation-induced proctitis https://connect.mayoclinic.org/discussion/radiation-induced-proctitis/

See all: https://connect.mayoclinic.org/group/prostate-cancer/

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Diarrhea started during my 44 weekday IMRT treatments in March, 2025 and lasted until December when a support group pointed me to daily Psyllium husks and probiotic capsules. The diarrhea stopped but I still have 3-5 loose bowel movements daily. I was diagnosed with radiation proctitis through a colonoscopy in January, 2026 and have recently completed four weeks of twice daily sucralfate enemas. I had slight bleeding which stopped early in the enemas series, but no change in bowel frequency. I have sent a message to my gastroenterologist about trying Mesalamine, which someone in this forum mentioned as giving significant relief. Best wishes!

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