Blood in Stool 3 months after Proton treatment

If I had blood coming out of an orifice that it had never come out of before, I would not consider it “normal.”
If it were me, I would get it checked - might be unrelated to the treatments; might be related. (Rectal bleeding could be due to any type of injury along the digestive tract, colon, or rectum).

> did you use a rectal spacer?

Two possibilities

This can happen if you have hemorrhoids even if you don’t strain.

And then there is radiation proctitis which is more likely
Yes, blood in the stool three months after prostate radiation can be a problem, often a sign of radiation proctitis, where radiation damages the rectal lining, causing fragile blood vessels to bleed, but it's common and usually manageable with doctor guidance, though it needs checking for severity to rule out other issues and determine if treatments like stool softeners, diet changes, or procedures are needed.

robertov, usual, not normal. It is radiation damage to the epithelial layer of your rectum called proctopathy but also called proctitis. Sometimes it is acute and goes away, more often with this pathology it becomes chronic.
The outer damaged layer sloughs off and tries to produce undamaged blood vessels, but usually (with radiation effect) the new vessels are also damaged. Radiofrequency can be used to stop the bleeding. The best form of radiofrequency uses a special wand that controls the depth and the heat specifically for radiation proctopathy.
https://pmc.ncbi.nlm.nih.gov/articles/PMC3539292/
Some people just tolerate it, but for others it can cause anemia.

@brianjarvis Yes, used Barrigel. Was done at Mayo. First time anything other than urinary issues.

@gently Thanks! As usual, I think you may be right. It didn’t happen the day after (faint, not even sure blood). I am going to monitor for the next week before I worry.

@jeffmarc Thanks Jeff! Informed my care team. Hadn’t thought about hemmorhoids as I am rarely bothered by blood after BM. It didn’t happen the next day (faint maybe). I’ll continue to monitor, I am so regular that I thought I was past any issues. I’ve calmed down since yesterday . 🙂

@robertov Interesting. Both Barrigel and SpaceOAR report “…significantly reducing rectal toxicity (bleeding, diarrhea) and improving urinary (GU) & sexual quality of life (QoL)….with studies showing better preservation of erectile function and fewer bowel/bladder issues post-treatment.”

Still, sometimes it can happen…..

I’m not yet convinced it is rectal damage. Looking into it further, 3 months may be about the time that affected cells might be sloughed off. But doing a wait and see if it happens again.

It isn't abnormal. I have radiation proctitis from radiation 9 months ago and the bleeding is slowly, ever so slowly resolving itself. You might even see some specks of blood floating in the bowel too. I had horrible bowel urgency shortly after completing radiation and total lose of control during those events. Crapped all over myself a few times. Radiation doctor blamed it on me saying I had wipe blood. Fired him and the practice after radiation.

Wow well here I am trying to get approved for Proton in Atlanta, Ga. It’s not available here in Puerto Rico.. I am up to start VMAT which I read is pretty good. They say I’m eligible for Photon I sent all my records and a negative PSMA results. But still gave to see the oncologist there for final approval or not! But now I need a letter from my oncologists here saying why for proton etc etc to justify my insurance paying for it. I think it’s a lo better and safer in all I read. Have my prostrate, no surgery, on Lupron only 2 months now and my PSA is 0.03 which is good. But anyway I still a lot about ppl saying photon better results and minimal side effects. Hope everything gets good for you.. I’m struggling with this radiation thing oh and brachytherapy I’m supposed to have too. I have read that with Proton brachytherapy may not even be necessary so many things I don’t know. Best to all