Radiation prep FLEET ENEMA nightmare: HELP

Hello ALL

I have started radiation therapy for my pc. At a major highly regarded hospital.
The technology is cutting edge.....the Dr. is superb at looking at the big picture...

But getting through it has been a nightmare so far. Each nurse has slightly different advice when I call with an issue, which is confusing and could be potentially dangerous.

The problem I am having is GAS in the area that they are aiming the radiation at. They had to stop my treatment because you can't do it with any gas bubbles in the area.

First of all they really don't stress a low fiber non gassy diet nearly enough....

and the protocol does not seem to be working...in fact its creating to much gas to proceed. I am totally amazed that they often get backed up with patients because so many of them have too much gas to continue. So they have patients waiting and waiting for time on this very expensive machine yet they don't adjust a protocol which is not logical and wastes everyone's time money....and who needs the extra stress at this sensitive time.

So perhaps there is someone out there who can suggest how to tweak they're protocol so that I can be treated and survive somewhat intact.

protocol: 2 gasex 125 mg at night and in the morning
(people in radiology ask? Why are you taking the gasex early in the morning when your procedure is late afternoon. Some of the nurses suggested that, others say "just follow the protocol and you will be fine" NOT!!!!!

First thing in the morning take a heaping teaspoon of Metamucil (the expert guy at my healthfood store says that whole husk Psyllium is less gassy) I would take it at night but I get home around 6 or 7 and cannot drink all the water needed...plus I can't be up all night urinating because I have trouble starting a stream at night and can't be up all night going to the bathroom. I am already having bad urinary side effects and peeing really hurts (just started that stuff that makes your urine orange but takes away the pain) Yet I can't see how taking it in the morning won't make you more gassy for the procedure.

Then comes the worst part:

Then take a fleet enema 3 hours before the procedure.
(First of all...the enema tares my stomach to shreds) and I think that is the major cause of the gas. I think taking the enema on an empty stomach after earlier taking Psyllium fiber is just making things worse. I've read its better to take it on an empty stomach....so an empty stomach with just fiber powder seems to not make sense to me.

They insist I have the enema (and I know many tolerate it very well) but not I.
They will not do the procedure without the enema. So my only food of the day would be after the enema and before leaving which dosen't leave much time as with my system the enema has me going to the bathroom for hours. And then cramps and my stomach is in knots. So going in for the procedure around 4 that usually ends up being more like 6 pm with very little food in me...except for a fleet enema and a dose of fiber powder. With the stress and little food after the enema I get majorly gassed out. And that is with eating a low fiber non gassy diet.

I have to do the enema at 10:00 Am or 11:00 AM

Hopefully someone can suggest a way to tweak things so I have little or no gas and can have the procedure done and get myself cured.

I know many on this forum use the enema all the time...but for me it is a battle.
I would greatly appreciate any input.

Thanks and wish me luck. It looks like I will need it.

I've gone to a low gas low fiber diet. I don't think that should cause gas. Its obviously meant to lessen gas. That is what they say to do when you have gas...right?

Before I was on a high fiber diet very healthy and took psyllium as well with no gas. Although I do have digestive issues, That's why I have the very healthy diet.


As I said I think its the combo of Metamucil or just the fleet enema.

I called the company and yes they say the fleet enema can cause severe gas and bloating in some. That comes with cramps and abdominal pain. I cannot believe they don't have any alternative to using the fleet. So what I think I need to do is manage the enema so it won't do that to me. That is what I'm asking for information about. Empty stomach, full stomach. I've read take it on empty stomach. That's all I the info I have found.

thanks a lot for asking!

Post Edited (fuzzboxman) : 10/27/2017 4:00:30 PM (GMT-6)

its in the protocol to take a teaspoon of fiber sup a day. I've taken that for years without this kind of issue. I appreciate the low fiber diet you listed and I'm well aware of what to eat. Just got cream of wheat and cream of rice. Perhaps I will go off their protocol and stop the fiber sup. Although I have major constipation issues and that's why I really need it. Plus hemorrhoids that can get nasty. Perhaps a low fiber diet that is easily digestible will do the trick.
Odd they never suggested that. They are like robots and use a one fits all protocol for everyone. Crazy.

Eating the right stuff. The big change is the enema which can cause gas (I called the company) gas, bloating, cramps. I got them all.

Thanks

FUZZ,

WHAT METHOD OF RADIATION ARE YOU HAVING DONE. CAN YOU ELABORATE A BIT MORE?

MY HUSBAND WAS TOLD HE MAY HAVE DIHARREA AND TIREDNESS HOWEVER NEVER MENTIONED GAS WHEN HE HAD RADIATION.

BOOGEE

its SHARP like SBRT

Since you only have 5 treatments I guess they really want a clear view. They used to not give the enema but as I said...these days most places use it for that type of hi powered radiation.

Most places giving it do require the enema. As I've said before "I've been taking fiber for years" without issues. Its gotta be the enema. But perhaps leaving the fiber supplement out could help....although I need it because I have digestive issues with constipation and hemorrhoids.

The fart tube is a rectal catheter and you don't want to ever even see one...well maybe in one of those Hostel movies where CEO's pay to torture people for fun.

I just finished eight weeks of IMRT and had terrible bowel problems. Normally I am as regular as clockwork... a cup of coffee and a few minutes on the throne. Nothing special, and no problems. But frequent diarrhea and "explosive" gas started the second week of RT.

The RO has everyone on the special low fiber diet mentioned above by searchinginla. RO said that some bowel disruption was to be expected and recommended Activia 2X daily. The Problem became more sporadic but persisted. Ultimately I eliminated nearly all fruits and vegetables, and ate lots of rice. Still having multiple BM's on some days, unusual for me, but everything works okay. No more gas.

I had asked about the rectal balloon and my RO said some RO's use it and some don't. The primary requirement for mine was a quart of water 90 minutes before RT. Rectal catheter? I'd be curious just to see that one, but it sounds more like one of the spoof commercials from SNL.

No specific advice, but wanted to add I was told to avoid carbonated beverages (no pop, beer, nothing). No doubt you're already doing that too, but thought I'd mention it.

Thanks....yeah. I only drank vanilla seltzer with my vodka. But not now!

I didn't even consider gas a SE from the RT. Since I had it on treatment #1 I don't think that was the case....Even though there was no gas my stomach felt really bloated from the enema as it always does.

I'm surprised that there isn't someone with advice on how to use an enema with the least problems...maybe using a certain food before or after..or drinking warm water..etc...

I know many guys need to use them for all those procedures we have to endure.
But I suppose....
If the saline solution.... does not go well with your constitution (it rhymes...I'm a songwriter-really) then there is no "better" way to take it.

Sorry your having problems with an enema - I have never seen any studies about an enema. It's usually just considered a precaution to clear out the rectum so that nothing is inside there pressing the rectum against the prostate. No one considers it a big deal. I recall doing one before my biopsies and my fiducials. But if you can somehow clear the rectum out without an enema, I don't really see what difference it makes. And if you have such a reaction against the enema that it's causing rectal gas that preclude treatment anyway, and I've honestly never heard of this before, just talk to your RO about it. Maybe they can use a different solution that you won't have such a reaction to.

In trying to rationalize the extra hurdles I have to go through (enemas)
I have found that many or most of the places using cybernife type procedures at this point in time are into that enema prep. Some places make you do a whole procedure like you are having a colonoscopy. I'm not saying its always warranted...just saying its done.

To the point of MSKK using it...I was thinking about it. It doesn't make it easier for them at all. In fact often if they feel someone isn't "Clear" enough down there they will stop the procedure...give him another fleet at the hospital and then do the procedure. This adds more delays and time spent getting the patient readied. Obviously they must think it makes enough of a difference to go through all that trouble. I will ask if there are any studies on this.

I was cautioned about gas when I was getting my IMRT introduction/overview by one of the radiation techs. Too much and they won't start the treatment. I'm on stool softeners and managed to clear my bowel and get hydrated before going each time for radiation. When they were doing the imaging for IMRT planning, I had to have a clear bowel (enema time - yuk.) Only one time I had a bit of diarrhea during my 33 sessions, other than the tiredness, that was the extent of SEs (but again this was IMRT.)

If gas is a problem, maybe a rectal spacer such as SpaceOAR System or hydrogel rectal spacer might be a benefit. Using these can give several extra millimeters separation between the rectal wall and the prostate.

fuzzboxman - First, I remembered exactly what the box was. I don't play, but I do remember being at many concerts where those things were used. I have the hearing aids to prove it now.

I, too, had lots of digestive/intestinal issues prior to my CyberKnife treatment. I knew it was a risk, that it might be exacerbated, but having had too many major surgeries already (open-heart, etc.), I felt that radiation and its side effects were the lesser of the two evils.

I was able to tolerate the enemas for the Fiducials and all 5 treatments, but I did modify my diet during the treatment period. At my RO's suggestion, I temporarily halted my Metamucil for the two weeks. After the first treatment, my system "flowed" almost too well even without the added fiber. I did, however, continue my probiotic daily, also at my RO's suggestion. She said that sometimes they advised patients to start probiotics and stay with them until things settled down. Since I was already using one, she just said to stay with my normal dosage. I only had my treatment stopped one time due to gas (and CyberKnife treatments were 45-60 minutes each), so I was lucky.

I also ate a very overly simple diet during treatment. Absolutely no fried foods, no cruciferous vegetables and even cut back on carbs like bread and potatoes, as they can also cause gas. I did lose about 5 pounds during that time, but gained it right back once I returned to my regular diet.

I hope that you don't have lasting intestinal after effects. I did for a few months, but they gradually subsided and by about month 6, my digestive tract was totally back to normal.

Hang in there. If things get too far out of place, they will stop the treatment. They don't want to torch any part of you that isn't part of the plan. You're almost there.

P.S. I also used Gas-X. I wasn't sure if it was helping, but thought it couldn't hurt. Maybe temporarily increase the dose?