Bowel problems
Following radiotherapy to treat my endometrial cancer, I found my anus and rectum had sustained damage.
I had a restricted blood supply due to damage in the blood vessels; fibrosis which is a development of excessive tissue or scarring, and ulceration which is when a healing wound develops on the skin.
At first, I was unable to sit or lie down properly. I was losing a lot of blood from the back passage. Around 9 months after my problem started, I was referred to a gastroenterologist who has a special interest in radiation damage.
I had a sigmoidoscopy examination. Sigmoidoscopy is a flexible tube to help look into the sigmoid colon and the rectum. After that a proper diagnosis was made and treatment was given.
Incontinence can be difficult to deal with. It was frightening to leave the house in case I had an 'accident.' I found that this worry affected my bowel, the stress made the likelihood of an 'accident' more likely.
Initially, I wondered how I was expected to live with such problems. Increasing lack of confidence and isolation made me question if the treatment had all been worth it.
Surgery and radiotherapy had caused me many adhesions in my pelvic area and these caused a lot of pain. They also caused vaginal, rectal, and a lower bowel narrowing. I used to cry each time I opened my bowels because of acute pain. I felt 'run down', alternately dealing with diarrhea or bowel blockage. I discovered this was sometimes caused by a small bowel bacterial overgrowth. I could not tolerate iced water, and had to reduce my coffee intake, both which caused violent diarrhea. My limited diet added to my problems, making it difficult to eat out with friends and family
One year after the radiotherapy treatment, my colon looked something like this picture below.
What helped to improve my symptoms?
I have used,
- 2 tablespoon of apple cider vinegar with honey, in a glass of water to help relieve painful bowel movements. Apple cider vinegar is a folk remedy used for many conditions including poor digestion. It contains pectin, a water soluble fiber that helps to improve the digestion by normalizing acid in the stomach and is believed to assist the body in performing the natural bowel movement.
- Natural vitamin E and pentoxifilin. Vitamin E is said to be a powerful antioxidant. Pentoxifilin is used to soften tissue by improving blood circulation. This treatment has been used successfully in Paris in patients with radiation related problems.
- Hyperbaric oxygen treatment.- This is used when blood vessels are damaged by radiotherapy to help blood vessels carry extra oxygen.
- Probiotics. These have helped me to balance my intestinal flora and reduce diarrhea. Bioacidophillis was recommended to me by a nutritionist at the Penny Brohn Cancer Center, but you may want to try various types until you find the right one for you. Your doctor may be able to help you to decide.
Vitamin E- According to the Food Standard Agency(1), Natural vitamin E can protect cell membranes by acting as an antioxidant. it can help soften tissue scarring. Because the side effects of high dose vitamin E are unknown I take a standard dose each day.
Pentoxifilin - A side effect of pentoxifilin is to lower the blood pressure . Pentoxifilin is only prescribed by a hospital doctor.When i started taking this drug, i started with a high dose per a day. My side effects were dizziness, tiredness and gastric problems. I then stopped taking it for a while, then started again by slowly building up the prescribed dose to avoid problems.
Radiotherapy can have ongoing effects on body tissue, but using the treatment above, my bowel frequency has improved over time.
DO
- Keep a glass of water handy and have small sips. It is important not to get too dehydrated.
- Take a look at your diet. Try eating bland, non greasy foods such as soups, grilled and steamed food. (A low carbohydrate diet has been a great help to me and I use olive oil for cooking.)
- Soft food may be more easily digested when the inside of the bowel has become thick and less mobile.
- Red meat is not easily digested.
- Although a damaged bowel may not be able to tolerate many portions of fruit and vegetables per day, it is important to eat a little if possible.(2)
Be aware that diarrhea causes loss of nutrients and bile, which aids food absorption.
Some medicines provide bulk to maintain a healthy bowel.
St Mark's hospital (3) - provides a very good patient information leaflet on medicines and normal bowel function.
The US National Cancer Institute has some useful dietary advice on gastrointestinal complications and radiation enteritis.(4)
In Contact is a national support organization for incontinent people and carers. They supply,'I just can't wait' cards for when outdoors near shops and public places).
There are some drugs available on prescription to help you with some of the early side effects you are having. It is always important to be honest and talk to your doctors about this.
St Marks hospital has a good information leaflet on how to take
loperamide, which is used for long lasting diarrhea. You have to
take your doctors advise when, how and if you should take this.
what to avoid eating and drinking.
- Eat or drink a large amount at a time.
- Avoid or limit iced water, coffee, berries, spices and hot dishes.
- Eat immediately prior to going out, otherwise the peristaltic movement of your digestive system may cause an 'accident'.
