Overview

People who have radiotherapy around the bowel as part of their cancer treatment can experience a side effect where the blood vessels in the bowel become fragile and easily bleed.

You may notice that bleeding becomes worse if you:

• are constipated 
• need to strain when you go for a poo (open your bowels)
• you need to poo frequently

The bleeding can also be affected if you are taking any medicines that thin your blood, such as antiplatelet medicines (such as aspirin or clopidogrel) or anticoagulant medicines (such as warfarin or rivaroxaban).

Most people notice occasional bleeding, and for some patients this bleeding becomes troublesome. Up to 2 out of 100 people have severe problems caused by radiation damage.  

Research suggests that, over about 5 years, problems caused by these fragile blood vessels will reduce but it will not go away quickly.

Having a sucralfate enema

Sucralfate is medicine used to treat people with bleeding from the lower bowel.

Giving sucralfate as an enema, means the medicine is passed directly into your lower bowel through your bottom. The medicine is inserted into your bottom using a small tube. Enemas are safe, gentle and surprisingly easy to use. Most people find it convenient and comfortable to use the enema at home.

People with troublesome bleeding should notice some improvement after about 1 week of the treatment.  

How a sucralfate enema works

Sucralfate forms a protective layer over the wall of the bowel and protects the fragile blood vessels from breaking.  

Using sucralfate enemas for a long time may also help these fragile blood vessels to heal and disappear more quickly. 

At first the treatment may seem strange or difficult, but with perseverance it can make a big difference to the bleeding.