Looking for tips on managing radiation-induced proctitis

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!

I had SBRT ( 5 sessions at 7.25 Gy with focal boost to 40Gy) in December of 2023. A Barrigel Spacer was placed..
I had a routine colonoscopy in November of 2024 at the following was noted:

“A few angioectasis were seen in the distal rectum. Likely secondary to radiation proctopathy. Patient did not report bleeding hence no intervention was performed.”

In July of 2025 I started noting some bowel urgency, blood on the toilet paper, and some blood on the stool. This occurred 4 times in July.
Since then I had been noticing it perhaps once or twice a month,
In April of this year it happened about 4 times again.
The distress and bleeding were minimal, and my Complete Blood Count was normal.

I started taking 400mg Vitamin E, 500mg Vitamin C, and 25,000 IU Beta Carotene daily on the first of May.
I have had no episodes of bleeding or urgency since starting this regiment.
I have no idea if the E, C and Beta Carotene have in fact helped, or if this pause in symptoms is just that......a pause like I have seen over the past year.
Time will tell.
If you are experiencing a similar problem it my be worth your time to give it a try.

Stay Strong Brothers, We Got This.

Radiation proctitis started during 44 IMRT treatments but was actually diagnosed nine month Later. I’ve taken sucralfate enemas for bleeding, mesalamine suppositories for frequency/urgency and am at 19 of 30 hyperbaric oxygen therapy treatments hoping for better healing. I usually have 2-4 bowel movements between 4-9 A.M. and then again before bedtime.

@jime51
https://pmc.ncbi.nlm.nih.gov/articles/PMC3539292/
I know several doctors in CA at Stanford, Scripps and USC if you need names. I had a terribly difficult time finding practitioners. But I have heard of resolution with HBO but I think it was with 40 session at UCSD.

@gently Thanks! I’m in Fort Worth TX area and fortunately the hospital for which my daughter works has chambers and clinicians. The current question will be what to do if 30 sessions have helped but aren’t enough. The specialist who administers the treatments says he has seen as many as 50 and a friend who had success with treatment for a leg wound says he’s heard of 60. Time will tell.

@jime51
I'm 80. I have both radiation cystitis and enteritis. I probably have radiation proctitis also, but my Gastro doctor has never had a patient with these issues. He is not much help. I had 30 HBOT treatments ending July 9. My issues started 9 years ago when the Proton radiation ended. Problems came and went over the years but no one could figure out what was wrong with me until I began bleeding from my bladder. My new urologist knew what was happening, diagnosed it and sent me to HBOT. At the same time radiation enteritis started full throttle. My only savior was AI. My wonderful wife ask thousands of questions to AI. We learned what I could and could not eat. I'm doing much better and am beginning to expand my merger diet. I lost 24 pounds since all this started with the bladder in April. My urinary system is working well and I'll probably get an artificial valve so I can stop using pads. My gastro pain has relieved and the explosive bowel movements have stopped. It's all because I'm eating the correct foods. Dr. Google has saved my life for now.
Good luck with journey.

@jime51
I'm 80. I have both radiation cystitis and enteritis. I probably have radiation proctitis also, but my Gastro doctor has never had a patient with these issues. He is not much help. I had 30 HBOT treatments ending July 9. My issues started 9 years ago when the Proton radiation ended. Problems came and went over the years but no one could figure out what was wrong with me until I began bleeding from my bladder. My new urologist knew what was happening, diagnosed it and sent me to HBOT. At the same time radiation enteritis started full throttle. My only savior was AI. My wonderful wife ask thousands of questions to AI. We learned what I could and could not eat. I'm doing much better and am beginning to expand my merger diet. I lost 24 pounds since all this started with the bladder in April. My urinary system is working well and I'll probably get an artificial valve so I can stop using pads. My gastro pain has relieved and the explosive bowel movements have stopped. It's all because I'm eating the correct foods. Dr. Google has saved my life for now.
Good luck with journey.