For the past two months I have been getting up three to four times in the night to empty my bowels. A colonoscopy ruled out cancer – I recently had treatment for prostate cancer – and I was told it might be diverticulitis so I should just eat more fibre. Do you have any suggestions? I’m 75.
Dr Ellie Cannon replies: Bowel issues can be a common consequence of prostate cancer treatment, as radiotherapy can damage the lower part of the intestines – the colon and rectum. This is called radiation proctopathy and is understood to affect as many as one in five people having treatment. If it first happens more than three months after the radiotherapy, it is called chronic proctopathy rather than acute, which happens straight away.
Typical features of this condition include incontinence and bleeding from the back passage as well as feeling the need to strain, diarrhoea and urgency – when you have to run to the toilet to open your bowels. It can also cause you to pass mucus, and how often you go to the toilet can also change, so starting to open your bowels at night could be a symptom.
Increasing soluble fibre in your diet can help those who have bowel issues. Emptying the bowels is controlled by the pelvic floor – a sling of muscle between the legs that supports the pelvic organs. Exercises to strengthen these muscles may help to control the urgency and frequency of the bowels from proctopathy. The GP can request a referral to a pelvic physiotherapist, who will be able to advise on these.
