getting scoped for proctitis

17 months after ending salvage radiation, I've been having on and off rectal bleeding. Usually just a tiny amount, but one morning this week it was quite noticeable. Radiation doc said he'd refer me to get a colonoscopy. But when Gastroenterology called, they said it would be a sigmoidoscopy.

I read up a little and it seems the sigmoidoscopy would cover the most relevant anatomy. Also, they said I'd be able to drive myself, and the prep isn't as severe. Anyone had a similar experience?

yes. Sigmoidoscopy covers the lower third of the colon and the area most likely to have been hit by the radiation. They generally do that without drugs and since they're not clearing the whole colon it's easier to do.

Rectal bleeding could be from a lot of things, many aren't that much to worry about. Also, just a drop or two can seem like a lot. Do have a conversation with the doc about what the different causes are and home treatments.

Sadly, in my case the sigmoidoscopy lead to a recommendation for a full colonoscopy.

I have been treated for proctitis - one laser treatment was all I needed.

Yeah, you don't want to be cauterized while awake. That's the risk of going to the non-sedation place - if they see something that needs to be zapped, you either have to come back or already have a driver with you.

Yeah. That’s frustrating.

It's probably radiation proctitis, that can show up well after RT is over. That's what happened to me.

A sigmoidoscopy may be all you need, but the recommended colonoscopy will better locate all issues.

Sedation is good ;-) and luck is even better!

Had no blood in the stool for 3 days, and got my hopes up. But pooped out what looks like a bloody clot today. Darn. At least my blood work is still looking normal, so the bleeding it not too large.

Also, PSA is still <0.1 (Kaiser still uses the old test.)

Bummer for the bleeding issues. I have had 4 colonoscopies in the last 4 years due to bleeding and previous polyps found. You have to go with whatever your doc orders but if they are up there, you might as well go all the way and double check anything else. Then you are good for a few more years or so. Quick cauterization should do the trick if the doc thinks it is warranted. Good luck. -JR

Sigmoidoscopy was today. I was awake for the whole thing. They were ready to sedate and cauterize if necessary, but it wasn't needed. There was a slightly irritated area that he said wasn't worth treating; it was healing on its own. And I haven't had any blood for a week, so I guess that correlates. He went a little farther than you need to go for a sigmoid, and there wasn't anything up there either.

It was funny because the nurses seemed really proud of their new argon plasma cauterizing machine, and they were all ready to use it, but didn't get to.

So unless I have more bleeding (knock on wood), apparently I'm OK for now.

Great news! Hope it stays that way for you.

I have a case of proctitis right now (at least hope that's the cause). I'm 5 years out from Proton radiation treatment and if it's proctitis it'll be the 3rd occurrence. The 1st at 6 months, 2nd at 18 months, and now this at 60 months. It's been ongoing for 5 months now and usually can't be seen, but every now and then it's clearly visible and sometimes with clots. GI doc recommended colonoscopy even though I had one 2 years ago. Nothing was found so that's good. His diagnosis is proctitis. My primary agrees, so does my Uro.

Ever since the colonoscopy 4 weeks ago I have had a recurring discomfort in my lower left side about 2 inches from the navel. It only occurs during movement and is fleeting. I dont recall it ever happening when sitting or lying down, Never lasts more than a second. Sometimes many times throughout the day, other times very few times in a day. I'll have it sometimes bending over but when I try to repeat it to establish a pattern I cant. I called my GI doc's office and spoke with his nurse who texted him and he doesnt know what it might be. My primary care doc examined me and didn't identify any likely causes either. He suggested it might be muscular or diverticulitis which could have been triggered from the colonoscopy. He ordered CT scan for next week. It seems it's always something

The sigmoidoscopy found an internal hemorrhoid and high up a small polyp so the doc recommended a full colonoscopy. I've had three colonoscopies, the sigmoid check was before radiation. When they suspected proctitis we decided just to go for the colonoscopy because of my history of having a polyp.

Radiation damage takes a long time to heal and often doesn't show up for a couple of years. There are lot things that can cause bleeding (hemorrhoids, anal fissure, constipation, etc) and most time the blood isn't a sign of anything horrible - especially bright red blood. Also just a drop or two in the bowel or on TP can look like a lot more that it is.

Over the years I've found that I just have to do a bit of self management to keep the bleeding down. I take a small amount of miralax daily, limit sugary drinks and sugar in general (really dries out your colon) plus have reduced my salt intake. I drink plenty of liquids and eat more veggies.

Thanks for the advice!

Generally bright red comes from lower in the colon - a colonoscopy might not show the source of that. Internal hemorrhoids or an anal fissure are more likely causes.

But I'm not a doctor, I just play one on the internet.

Andrew