Bowel challenges post radiation

Sounds like my experiences with post Radiation Proctitis and Radiation Enteritis. Big urgency with small loose stools and rank gas. Radiation Proctitis affects the Rectum and in my case bleeding like a period. The solution was getting a Sigmoidoscopy and cauterization of the small veins which worked well. I was prescribed 90 days of Mesalamine enemas for the Enteritis which is intestine inflammation that helped. He also might want to slowly add 20-25 grams of fiber into his diet if not already doing so. I found it kind of ties everything together for a fuller stool. Doesn't help with the urgency but cuts down on the trips. I use Oat Bran with my morning eggs and Raspberries mid-day, and it has helped. At 15 months post radiation and 6 weeks after finishing the Mesalamine I am close to normal. Two prong approach (pun intended). Sometimes ya just gotta go with the gallows humor. Best wishes on his treatment.

I had 44 IMRT treatments during February-April 2025. Diarrhea started in March and continued daily until December, when a support group recommended adding Psyllium fiber and a probiotic daily. Bowel frequency and urgency continued, with 4-7 movements daily. A colonoscopy confirmed radiation proctitis. I took a month of Sucralfate enemas to heal bleeding and two months of Mesalamine suppositories to help reduce frequency. Still struggling, I have completed 8 of an initial 30 hyperbaric oxygen therapy treatments in the hope of accelerating and supporting healing. I am typically in the bathroom 3-4 times between 4 A.M. and 9 A.M., then it usually stops until early afternoon or even bedtime.

@chippydoo thank you so much for your reply. I’ve already been working on getting in the fiber in his diet. Doesn’t seem so far to be making a big difference. I imagine we will be headed back to Mayo for a scope & diagnosis. Thank you for sharing - going to read up now on the Mesalamine so we understand before the appointment.

@jime51 Thank you for sharing! I’ve added the Psyllium & a probiotic for him-no real change yet. Very interesting hearing about Mesalamine from a few of you now so starting my morning reading. Thank you!

@anything4him I used a probiotic in capsule form. Supposed to survive stomach acid and actually get to the gut. Good luck.

@chippydoo Thanks!

First step is to get a medical diagnosis. Certainly related to the radiation treatments, but he needs a specific diagnosis in order for them to recommend treatment.

> Is the medical diagnosis radiation-induced enteritis (or is it rectal damage)?

> How did his full bladder/empty bowel routines go?

> Did he use a rectal spacer?

> If he’s really suffering and nothing else works, often hyperbaric oxygen therapy helps.

@brianjarvis
Thanks! Have a telemed with the GI on Tuesday so guess we will see what tests are next and hopefully get a solid diagnosis with a treatment plan afterwards. His prostate was removed prior to radiation so I’m sure he took a pretty serious hit. The full bladder, empty bowel during radiation was no problem. This situation is new - started 7 months after radiation but I’ve read that can happen, sadly. I’ll post back as this unfolds so others can hopefully benefit from what we learn.