Samuel N. Marcus M.D., Ph.D.



Radiation Proctitis

Proctitis refers to a condition where the lower colon and/or rectum are inflamed. This inflammation can be so severe that it causes pain and discomfort, and can also interrupt normal bowel functions. While a range of things can cause proctitis, one of the most common causes is the radiation used to treat colon, ovarian and rectal cancers. When this occurs, we refer to the condition as radiation proctitis.

While radiation is often effective at treating the larger problem – cancer – the treatment itself can have negative side effects. Patients who experience radiation proctitis most typically experience rectal bleeding, which can begin as early as four to six-weeks after the initial treatment, for as long as nine-months after the radiation treatment has ended.

Dr. Marcus provides diagnosis and effective treatment of radiation proctitis here in our Mountain View Endoscopy clinic.

How is the Condition Diagnosed?

In addition to rectal bleeding, patients with radiation proctitis may also experience:

  • Bloody bowel movements (one of most notable signs of rectal bleeding)
  • Pain in the anus or rectum
  • A feeling of fullness in the rectum
  • Abdominal pain, typically in the form of cramping
  • Rectal discharge, either mucous or pus
  • Chronic diarrhea or loose stools

In most cases, your doctor will listen to your symptoms and record your medical history. If you’ve had radiation therapy, radiation proctitis would be the natural diagnosis. However, Dr. Marcus will need to do use diagnostic procedures to be sure –so you can determine the best method of treatment.

Diagnostic measures for radiation proctitis include sigmoidoscopy (anoscopy), flexible sigmoidoscopy or colonoscopy (for cases where inflammation affects the greater colon). The results of these diagnostic tests will determine which form of relief and/or treatment will be the least invasive and the most effective.

Can Radiation Proctitis be Treated or Healed?

Yes, in most cases, we can provide some level of relief or treatment from radiation proctitis. The key is to come in as early as you notice symptoms. For patients whose tissues are already weakened from cancer and/or their cancer treatments, earlier treatment prevents a worsening of the proctitis. If you wait too long, there is a chance that treatment will be more difficult.

In worst-case scenarios, untreated and sever cases of proctitis can lead to infections that compromise the rectum and lower colon, and can even require a re-sectioning of the lower bowel to remove inflamed tissue that is beyond repair. Getting your rectal proctitis in check will make you more comfortable and will allow your body to heal – rather than worsen.

When radiation proctitis is mild or caught very early on, you may not require any treatment at all. Sometimes, prescription-strength anti-diarrheals and a modified diet will be enough to calm the inflammation such that the body can take over the natural healing process. You may also be instructed to take over-the-counter pain meds or anti-inflammatories until the symptoms have receded.

More moderate cases of proctitis may require the addition of a topical anti-inflammatory – often prescribed in the form of a suppository or enema.

If rectal bleeding is perpetual and/or severe, Dr. Marcus may recommend treating it using Argon Plasma Coagulation (APC). This is a newer, heat-based therapy that removes the affected tissue layers so new, healthy tissue can grow back in its place. APC is not quite involved as laser therapy and is more cost-effective.  In severe cases, you may require multiple APC treatments.

Sometimes, severe inflammation can cause a rectal stricture, meaning the rectal passage becomes narrowed, impeding normal bowel functions. Mild rectal structures can usually be treated with stool softeners. If the stricture is more severe, it may require manual dilation.

If you are experiencing the symptoms of rectal proctitis, contact Dr. Marcus and request a consultation. The sooner we can determine the source of your discomfort or bleeding, the sooner and more effectively it can be treated. (650) 603-5436.