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Bowel problems after RT

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User
Posted 10 Mar 2020 at 18:56

I am about 4 weeks out of radiotherapy (20 sessions, 60gy in total) and have 1 months life left in my second and final Zoladex injection.


During my eot discussion I explained that a previously innocent little haemorrhoid, which never bothered anyone, had grown into a vicious beast. I was prescribed Proctosedyl to use for about a week, and then to go onto Anusol. I continued with Anusol for a couple of weeks (apparently you shouldn’t use it for longer) as the pile is causing pain during and after pooing. I am also plagued by mucus farts, which means getting up through the night. I should add that neither the Proctosedyl nor the Anusol helped. Paracetamol barely helps. Is this condition likely to improve over time? My GP could offer no suggestions.


Also, my bowel movements are very erratic. They are mainly soft, and made about 3 times a day. However, occasionally they turn very soft and explosive. Again, will this improve? 

User
Posted 10 Mar 2020 at 20:12

I'm approaching a year since I finished my RT. The "mucus farts", which caused a few "accidents" in the first few months after RT gradually became less and less frequent and have now entirely disappeared. I do occasionally get mucus passed during bowel movements, but it's not a problem. Bowel frequency isn't the same as it was prior to RT; more frequent and much softer. Again nothing that causes a problem. Like Peter, I generally take an Imodium tablet in the morning if I'm going out for a day's walking, for example.


So things are different to before RT, but not in a way that I'd regard as in any way a problem.


Best wishes,


Chris

Edited by member 10 Mar 2020 at 23:19  | Reason: Not specified

User
Posted 10 Mar 2020 at 23:16

I'm 7 months on from EBRT and HDR brachy.
Mucus farts have diminished, but certainly not gone.
Bowel motions probably twice as often as they were, but not a problem.
Never taken imodium, and can hold if necessary - no incontinence.
I still pass fresh blood occasionally which has got a bit worse recently. Will mention at next appointment, but I believe that's not unexpected. No pain.
Occasionally get a couple of days of perfectly normal bowel movements!

User
Posted 11 Mar 2020 at 13:29
'Rules' for prostate cancer patients - add to the list, please!

1. Never pass a toilet. Use it.
2. Never trust a fart!

Hermit.
User
Posted 11 Mar 2020 at 18:26
Bill,

Sorry you have suffered as you relate. Interesting that you were prescribed Bepanthen cream which as you say is very mild. It was prescribed for me when I had some soreness with RT. For slight piles I also used another ointment which stung considerably for maybe 15 or so minutes and then reduced swelling and pain. It was much more effective than Anusol (spelling?) or anything else I tried but is no longer made, maybe because the smell was so strong people were turning to other things! When I am very occasionally sore, usually induced by having the runs I use an ointment called Xyloproct which contains Lidocaine and Hydrocortisone. It is a prescription ointment which helps and tempting fate say I have not needed to use for quite a time.
Barry
User
Posted 11 Mar 2020 at 10:15

I too suffered from the 'wet farts', with mucus and a bit of blood, both during and after my 20 sessions of therapy. The Radiotherapist prescribed a preparation called 'Budenofalk 2mg rectal foam' - basically small cans of 'shaving foam' which you inject into the bowel via a cardboard nozzle (the foam, not the can!). Easy and painless. It is a steroidal product and it seemed to calm things down very effectively. I had a pack of 10 but only needed to use seven of them before the problem sorted itself out. Worth asking about.
regards,
Hermit

Edited by member 11 Mar 2020 at 10:17  | Reason: Not specified

User
Posted 25 Jun 2020 at 09:23

Yes, as Lyn says, tell the radiographers. They can judge if you need some help, or just advise if a symptom is expected and can be ignored.


The sensation of needing to do a #2 when there's nothing there is sufficiently common during RT, it's pretty much expected. It even has a medical name (which I've forgotten).


This is why it's really important not to strain to try and go. There may be nothing there, but the straining can break blood vessels and cause more bleeding. You'll probably get some bleeding anyway - that's also expected, but you don't want to make it worse than it would have been. When you go, don't be in a rush, take a book or a smartphone with you if necessary. (Don't spend too long on a loo seat though - it's not great for circulation in the legs.)

User
Posted 25 Jun 2020 at 14:59

The constant urge to go even when there's nothing there is a medical condition called "tenesmus", and is a very, very common side-effect of RT. Those of us who've had RT might crack jokes about our experiences, looking back on it, but I well remember it being pretty unpleasant at the time.


Symptoms generally peak about 10-14 days after RT finishes, and then (in my case at least) subside rapidly. I had quite frequent "wet farts" for some months after, but these subsided in frequency and now, 15 months after finishing RT, it's probably 3-4 months since the last occurrence. Now all I get is mucus passed with bowel movements - that'll be with me for life. The other symptom I had in the first few months after treatment was proctitis, which is a burning sensation inside the back passage. This would last for 2-3 days at a time. It's probably 9 months now since that last happened.


I used to be a regular "once a day" man; now it's typically 2-3 times a day. Again that'll be with me for life. I take an Imodium tablet if I'm going out for the day and that takes care of that.


Chin up. I know it's probably pretty miserable at the moment but things will start getting better in a few weeks.


Best wishes,


Chris

Edited by member 25 Jun 2020 at 15:02  | Reason: Not specified

User
Posted 10 Mar 2020 at 19:56
I can't comment about the haemorrhoid situation but the mucus and bowel situation sounds same as me after RT and during Zoladex implants. The mucus did settle down and disappear on its own after a fairly short time. Had a few bowel accidents whilst out and about due to the urgency, movements were pretty soft for a while. I didn't take any medications it but have to say Immodium was great for days out etc and I was advised to eat more fibre as it actually helps bind thins together. No issues for quite a while now.
Peter
User
Posted 10 Mar 2020 at 22:39
Somtimes piles can be managed with medication but there can come a point where surgical intervention of one sort or another may be needed. This can be painful as two people I knew had it testified. But if needed procedure best done before you are old. I would get some informed advice on your situation.

My 'wet farts' and occasional 'runs' diminished over time and I believe this is typical.
Barry
User
Posted 11 Mar 2020 at 08:05

Originally Posted by: Online Community Member


Somtimes piles can be managed with medication but there can come a point where surgical intervention of one sort or another may be needed. This can be painful as two people I knew had it testified. But if needed procedure best done before you are old. I would get some informed advice on your situation.


 


 


I suffered with hemaroids for most of my adult life which also contributed to IBS. At times the pain was so bad I was completely incopasitated. I had some surgicaly removed but they returned within a month. The ten years or so leading up to Pca diagnosis I spent more time with a flare up then not. Also by then I had occasional anal fissures. Approaching Pca diagnosis over three years ago the DRE was agony and when told I needed a biopsy I was terrified. I was referred to a colorectal surgeon to try and find the underlying cause. Already prescribed a special cream many times, I can't remember what, something like rectogel or rectogesic I think, he told me to use it alternately with Bepanthen which is just nappy rash cream. Also sitting in a bowel of hot water helped. About three weeks later it was biopsy time and both my fissures and hemaroids were not to bad. The TRUS biopsy for me was nothing short of barbaric. I have continued to use Bepanthen liberally a bit inside and out after every shower and bowel movement ever since and have not had a single flare up since, something I could not imagine happening just over three years ago.


The point of this post is just to show those with chronic anal pain due to fissures or hemmoroids who like I used to, think there is never an end to it, that there is hope and light at the end of the tunnel.

Also Fibregel is very good for both diarria and constipation. When you are told to avoid fibre because of diarria they mean avoid non soluble fibre like wheat, bran and some vegetables etc. Fibregel is high in soluble fibre and absorbs moisture and forms bulk. 

 

Cheers

Bill
User
Posted 11 Mar 2020 at 10:31
The worst ones are when you don't realise you have done them until much later :( :(

I considered superglue at one point (only half kidding)
User
Posted 11 Mar 2020 at 13:54

Originally Posted by: Online Community Member
'Rules' for prostate cancer patients - add to the list, please!

1. Never pass a toilet. Use it.
2. Never trust a fart!

Hermit.


Rule 1: I take after my late father and have always followed it. Whenever I get to a new place I automatically scan for the nearest bog. Annoys the hell out of the wife!


Rule 2: found that out to my cost. 


Rule 3: wear trousers with zips not buttons

Edited by member 11 Mar 2020 at 13:55  | Reason: Addendum

User
Posted 11 Mar 2020 at 14:10

The zips not buttons is absolutely a thing!

User
Posted 13 Mar 2020 at 08:26
Just a quick update. I came across a leaflet from Harvard University Hospital covering my very topic. In it, they suggested after wiping with a babywipe (which I have been doing - cheap ones on offer from Morrisons), wipe with a Witch Hazel pad. Bit sceptical, but I ordered some from that South American river, and tried them. After a couple of days I was noticing reduced pain after a motion, and it seems like my pile is actually reducing in size. However, not having the neck of a giraffe, I've been unable to verify visually. My wife refuses to assist. I am now virtually pain-free (touch wood).
Thought it might be useful.

PS the mucus is reducing, but it would probably be doing this anyway.
User
Posted 13 Mar 2020 at 13:09

Originally Posted by: Online Community Member


Originally Posted by: Online Community Member
Upload a photo Buffalo, we will give you feedback


šŸ˜§šŸ˜


That really is funny but realistically your mobile phone camera is actually very useful in these circumstances.



I have a photo album on my iPhone which charts the progress of the spectacular bruising I had following my template biopsy šŸ˜

User
Posted 13 Mar 2020 at 14:20

Originally Posted by: Online Community Member
That really is funny but realistically your mobile phone camera is actually very useful in these circumstances.


That reminds me, I think I might have been the first patient to hand my mobile to the HDR brachy nurse when I'm laying on my back with my legs in the air and ask her to take some pictures of all the brachy tubes hanging out of my perineum. (There are times when you are all so grateful we can't upload pictures here, even if you didn't know it.) We see each other occasionally in the corridors now and then, and always laugh as we pass by.

User
Posted 25 Jun 2020 at 00:34

Hope this isn't too late (3 and a bit months!) to post something on here, but I have just passed (pun intended) the half-way point in my EBRT (11 fractions out of 20). The last three days, the side-effects have seemed to multiply and intensify beyond belief! I had the pain while urinating last week, but now it seems to be growing quite a bit worse. But now, the new problem. I see you're all talking about mucus farts and the like, but is this what you mean by it? I believe that I have developed Radiation Proctitis (I love looking things up, me!) Which means that I feel a constant urge to empty my bowels all day, every day and when I do go, or even just try to go, I either pass nothing, or small bits of brown mucus-y stuff. With the latest development, being blood. I just went ten minutes ago and, as usual, passed about 20 different little bits of blood, with nothing else. I am also getting quite intense pain in the bowel region, which again, lasts all day. Then there is the other thing, where I think I need to go and actually start going, before being able to do anything about it! Thankfully, that has only happened twice since the weekend. I now dare not leave the house without wearing a pad, which is embarassing and really hot, especially in this mini-heatwave! I tried to post this elsewhere on a new post, but it just says "Access Denied!" and won't let me post it, so I hope, as this seems the most similar to my problem, someone sees this and can maybe suggest something to help? Thanks!!

User
Posted 25 Jun 2020 at 01:29
Mention it to the RT team tomorrow - they may be able to prescribe colifoam or its equivalent - or at least review your diet with you.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 25 Jun 2020 at 16:54

Thank you all very much! That helps a lot. Yes it's a very lonely path going to RT on your own, especially during this whole lockdown/virus thing, so getting some help from those in the know gives me a lot of confidence! I said something to the radiographer and nurses today and they've arranged for me to see a doctor tomorrow, (who had just gone home five minutes before I arrived). I was more of a 'once every four days' man myself, but that's in the past! Going once a day is a surprise to me, but now I've gone 14 times in 24 hours, I'm quite exhausted! Anyway, thanks again for your help. Colifoam you say? I hope it's not made from cauliflowers! But I'll mention it. They don't seem to like giving anything out and only ever talk about paracetamol (or Tamsulosin which I really can't stand)!

User
Posted 02 Jul 2020 at 17:38

Ross
For most of my adult life I suffered with piles and fissures to the degree that the pain was so bad that I couldn't tell the difference between needing to fart or a bowel movement. About four years ago I was told by a colorectal surgeon to use Bepanthen which is nappy rash cream. He said it's perfectly safe and you can't use to much, either in or out. It relieved the soreness and helped with healing very quickly. I use it still after every bowel movement and I haven't had a flair up since. Might be worth a try.


Good luck
Cheers
Bill

Edited by member 02 Jul 2020 at 17:59  | Reason: Not specified

User
Posted 04 Jul 2020 at 22:17
Ross, the peeing every hour is entirely normal in the final stages of RT. It'll probably continue or even get worse until about 10-14 days after your RT ends, but then should quickly improve. I remember being absolutely shattered through having to pee every 45m all night long and hence complete lack of sleep.

The end is in sight. This is is the tough part, but you WILL get through it.

Very best,

Chris
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User
Posted 10 Mar 2020 at 19:56
I can't comment about the haemorrhoid situation but the mucus and bowel situation sounds same as me after RT and during Zoladex implants. The mucus did settle down and disappear on its own after a fairly short time. Had a few bowel accidents whilst out and about due to the urgency, movements were pretty soft for a while. I didn't take any medications it but have to say Immodium was great for days out etc and I was advised to eat more fibre as it actually helps bind thins together. No issues for quite a while now.
Peter
User
Posted 10 Mar 2020 at 20:03
Thanks for that. I remember now the nurse gave the same advice regarding Immodium. Paradoxically I was advised to avoid high fibre for a while! Although my first thought was to increase fibre for the same reasons you give.

Iā€™m finding that wiping with a Witch Hazel pad after cleaning with a babywipe helps reduce the pain.
User
Posted 10 Mar 2020 at 20:12

I'm approaching a year since I finished my RT. The "mucus farts", which caused a few "accidents" in the first few months after RT gradually became less and less frequent and have now entirely disappeared. I do occasionally get mucus passed during bowel movements, but it's not a problem. Bowel frequency isn't the same as it was prior to RT; more frequent and much softer. Again nothing that causes a problem. Like Peter, I generally take an Imodium tablet in the morning if I'm going out for a day's walking, for example.


So things are different to before RT, but not in a way that I'd regard as in any way a problem.


Best wishes,


Chris

Edited by member 10 Mar 2020 at 23:19  | Reason: Not specified

User
Posted 10 Mar 2020 at 22:39
Somtimes piles can be managed with medication but there can come a point where surgical intervention of one sort or another may be needed. This can be painful as two people I knew had it testified. But if needed procedure best done before you are old. I would get some informed advice on your situation.

My 'wet farts' and occasional 'runs' diminished over time and I believe this is typical.
Barry
User
Posted 10 Mar 2020 at 23:16

I'm 7 months on from EBRT and HDR brachy.
Mucus farts have diminished, but certainly not gone.
Bowel motions probably twice as often as they were, but not a problem.
Never taken imodium, and can hold if necessary - no incontinence.
I still pass fresh blood occasionally which has got a bit worse recently. Will mention at next appointment, but I believe that's not unexpected. No pain.
Occasionally get a couple of days of perfectly normal bowel movements!

User
Posted 11 Mar 2020 at 06:57

I had few bowel issues until 6 months after radiotherapy when I started the mucus/ fresh blood thing. It got worse and after a year of putting a suppository up my bottom twice a day with minimal effect I eventually had laser treatment . This 99% resolved the issue however if I drink too much with spicy food it will bleed again. Never painful just annoying. 

Dream like you have forever, live like you only have today Avatar is me doing the 600 mile Camino de Santiago May 2019

User
Posted 11 Mar 2020 at 08:05

Originally Posted by: Online Community Member


Somtimes piles can be managed with medication but there can come a point where surgical intervention of one sort or another may be needed. This can be painful as two people I knew had it testified. But if needed procedure best done before you are old. I would get some informed advice on your situation.


 


 


I suffered with hemaroids for most of my adult life which also contributed to IBS. At times the pain was so bad I was completely incopasitated. I had some surgicaly removed but they returned within a month. The ten years or so leading up to Pca diagnosis I spent more time with a flare up then not. Also by then I had occasional anal fissures. Approaching Pca diagnosis over three years ago the DRE was agony and when told I needed a biopsy I was terrified. I was referred to a colorectal surgeon to try and find the underlying cause. Already prescribed a special cream many times, I can't remember what, something like rectogel or rectogesic I think, he told me to use it alternately with Bepanthen which is just nappy rash cream. Also sitting in a bowel of hot water helped. About three weeks later it was biopsy time and both my fissures and hemaroids were not to bad. The TRUS biopsy for me was nothing short of barbaric. I have continued to use Bepanthen liberally a bit inside and out after every shower and bowel movement ever since and have not had a single flare up since, something I could not imagine happening just over three years ago.


The point of this post is just to show those with chronic anal pain due to fissures or hemmoroids who like I used to, think there is never an end to it, that there is hope and light at the end of the tunnel.

Also Fibregel is very good for both diarria and constipation. When you are told to avoid fibre because of diarria they mean avoid non soluble fibre like wheat, bran and some vegetables etc. Fibregel is high in soluble fibre and absorbs moisture and forms bulk. 

 

Cheers

Bill
User
Posted 11 Mar 2020 at 10:15

I too suffered from the 'wet farts', with mucus and a bit of blood, both during and after my 20 sessions of therapy. The Radiotherapist prescribed a preparation called 'Budenofalk 2mg rectal foam' - basically small cans of 'shaving foam' which you inject into the bowel via a cardboard nozzle (the foam, not the can!). Easy and painless. It is a steroidal product and it seemed to calm things down very effectively. I had a pack of 10 but only needed to use seven of them before the problem sorted itself out. Worth asking about.
regards,
Hermit

Edited by member 11 Mar 2020 at 10:17  | Reason: Not specified

User
Posted 11 Mar 2020 at 10:31
The worst ones are when you don't realise you have done them until much later :( :(

I considered superglue at one point (only half kidding)
User
Posted 11 Mar 2020 at 13:29
'Rules' for prostate cancer patients - add to the list, please!

1. Never pass a toilet. Use it.
2. Never trust a fart!

Hermit.
User
Posted 11 Mar 2020 at 13:54

Originally Posted by: Online Community Member
'Rules' for prostate cancer patients - add to the list, please!

1. Never pass a toilet. Use it.
2. Never trust a fart!

Hermit.


Rule 1: I take after my late father and have always followed it. Whenever I get to a new place I automatically scan for the nearest bog. Annoys the hell out of the wife!


Rule 2: found that out to my cost. 


Rule 3: wear trousers with zips not buttons

Edited by member 11 Mar 2020 at 13:55  | Reason: Addendum

User
Posted 11 Mar 2020 at 14:10

The zips not buttons is absolutely a thing!

User
Posted 11 Mar 2020 at 18:26
Bill,

Sorry you have suffered as you relate. Interesting that you were prescribed Bepanthen cream which as you say is very mild. It was prescribed for me when I had some soreness with RT. For slight piles I also used another ointment which stung considerably for maybe 15 or so minutes and then reduced swelling and pain. It was much more effective than Anusol (spelling?) or anything else I tried but is no longer made, maybe because the smell was so strong people were turning to other things! When I am very occasionally sore, usually induced by having the runs I use an ointment called Xyloproct which contains Lidocaine and Hydrocortisone. It is a prescription ointment which helps and tempting fate say I have not needed to use for quite a time.
Barry
User
Posted 13 Mar 2020 at 08:26
Just a quick update. I came across a leaflet from Harvard University Hospital covering my very topic. In it, they suggested after wiping with a babywipe (which I have been doing - cheap ones on offer from Morrisons), wipe with a Witch Hazel pad. Bit sceptical, but I ordered some from that South American river, and tried them. After a couple of days I was noticing reduced pain after a motion, and it seems like my pile is actually reducing in size. However, not having the neck of a giraffe, I've been unable to verify visually. My wife refuses to assist. I am now virtually pain-free (touch wood).
Thought it might be useful.

PS the mucus is reducing, but it would probably be doing this anyway.
User
Posted 13 Mar 2020 at 08:52
Upload a photo Buffalo, we will give you feedback
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 13 Mar 2020 at 09:00

Originally Posted by: Online Community Member
Upload a photo Buffalo, we will give you feedback


šŸ˜§šŸ˜


That really is funny but realistically your mobile phone camera is actually very useful in these circumstances.

User
Posted 13 Mar 2020 at 09:40

Originally Posted by: Online Community Member


Originally Posted by: Online Community Member
Upload a photo Buffalo, we will give you feedback


šŸ˜§šŸ˜


That really is funny but realistically your mobile phone camera is actually very useful in these circumstances.



As long as the mucus farts stay away ...

User
Posted 13 Mar 2020 at 09:42

Originally Posted by: Online Community Member
Upload a photo Buffalo, we will give you feedback


I’ve only recently learned how to find my backside with both hands. What chance do I have with my medium-format camera?

User
Posted 13 Mar 2020 at 13:09

Originally Posted by: Online Community Member


Originally Posted by: Online Community Member
Upload a photo Buffalo, we will give you feedback


šŸ˜§šŸ˜


That really is funny but realistically your mobile phone camera is actually very useful in these circumstances.



I have a photo album on my iPhone which charts the progress of the spectacular bruising I had following my template biopsy šŸ˜

 
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