Gastroenterologist specializing in radiation enteritis/proctitis treatments

fran124

My husband recently completed RT for a biochemical recurrence of prostate cancer. He had a tough time getting through the radiation treatments due to enteritis and then proctitis that required treatments with oral steroids and a brief pause in his treatments. He was able to complete his treatments about 10 days ago but is still having some gi symptoms with fecal urgency and frequency despite adhering to the low fiber diet, lomotil and bentyl. We are hoping that these symptoms dissipate with time, but given the magnitude of his symptoms (the RO said he was exceptionally sensitive to the radiation), he is likely to need to see a gastroenterologist at some point. Does anyone know of a gi specialist with extensive experience treating problems resulting from radiation therapy??

Forherself

https://csn.cancer.org/discussion/328282/gastroenterologist-specializing-in-radiation-enteritis-proctitis-treatments

I used to work in a family doctor's office. You could make an appointment with your husbands primary care provider and ask them. Ask them about cancer care clinics in the area, or the University near you. They will look into finding the best referral. If your husband is seeing a urologist who is not part of a clinic, you can also call a gastroenterologist office and ask if they treat your husbands problem, and if not could they recommend someone.

Oldernow

fran124 -

Sorry to hear your husband is suffering with what sounds like "acute radiation proctitis." While I didn't have that issue during radiation treatments, I developed "chronic radiation proctitis" about 6 months following my treatment. My primary care physician recommended a gastroenterologist who scheduled a colonoscopy which determined I did indeed have radiation damage to the lining of the rectum.

I have learned this -

• The "acute" proctitis is usually self limiting and can resolve with few long term issues. Hopefully this will be the case for your husband.
• The "chronic" proctitis can cause long term issues. Fortunately (for me) I have been able to minimize the issues that come with this condition and am not suffering any quality of life issues. You mentioned a "low fiber diet." My treatment consists primarily of a "high fiber diet." I take a fiber supplement every day and that has greatly reduced symptoms including rectal bleeding and fecal urgency.

Since we are all different and respond differently to treatments I would make sure to get a referral to an experienced GI doctor in your area for advice on how to proceed.

Best wishes for a quick and positive outcome for your husband.

Oldernow

fran124

https://csn.cancer.org/discussion/comment/1716691#Comment_1716691

Thank for your response. He is definitely in the acute phase. He was told to follow low fiber during the radiation due to the radiation enteritis (diarrhea and cramping) and radiation proctitis (tenesmus, rectal pain and fecal urgency)he experienced during treatment. The enteritis symptoms improved after they were done with the radiation to the lymph nodes and the acute proctitis symptoms seem to be slowly improving now that treatment is finished. Before radiation, we always followed a high fiber diet and as he heals, we hope to start to add fiber and return to our previous healthier diet. He is scheduled to follow up with a gi specialist at the university of rochester which is close to where we live but I am not sure of her experience with radiation bowel injury treatments. I reached out on this forum in case there was a specialist that someone knew of that had extensive experience with radiation bowel injury. We cant change the amount of radiation that the bowel received at this point, but if there are any ways to prevent or mitigate the chronic phase symptoms or severe complications like fistulas or strictures, I would like to hear about them from an specialist's viewpoint. There are clinical research studies out there on a variety of treatments, but many of them are in Britain.

Old Salt

I hope that the U Rochester gastroenterologist will provide proper guidance.