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Rebecca Embleton: Understanding Bowel Dysfunction After Pelvic Radiotherapy
Rebecca Embleton/LinkedIn
Aug 28, 2026, 11:38

Rebecca Embleton: Understanding Bowel Dysfunction After Pelvic Radiotherapy

Rebecca Embleton, Lead Clinical Nurse Specialist Pelvic Floor and Bowel Disorder Clinical Nurse Specialist at County Durham and Darlington NHS Foundation Trust, shared a post on LinkedIn:

“Bowel dysfunction after pelvic radiotherapy: an often-overlooked survivorship issue.

What happens to bowel function after pelvic radiotherapy?

It’s a conversation we need to have more often.

Radiotherapy can be lifesaving.

But for some people, the effects on bowel function can continue long after treatment has finished.

Radiation proctitis is one potential consequence of pelvic radiotherapy.

Pelvic radiotherapy is used to treat cancers including prostate, cervical, womb or endometrial, rectal, anal, bladder, vaginal and vulval cancers, amongst others.

Symptoms can include:

  • Rectal bleeding
  • Urgency and frequency
  • Diarrhoea or looser stools
  • Mucus discharge
  • Tenesmus (that persistent feeling of needing to empty the bowel)
  • Difficulty emptying completely
  • Abdominal or pelvic pain
  • Faecal urgency, leakage or incontinence
  • Increased wind or difficulty controlling it.

And these symptoms can have a huge impact on quality of life.

From my perspective as a pelvic floor and bowel disorders specialist nurse, one of the most important messages is:

  • Bowel problems after pelvic radiotherapy shouldn’t simply be accepted as ‘just a side effect of treatment.’

Pelvic radiotherapy can cause changes to the bowel lining, bowel wall and the muscles involved in continence.

For some people, these effects can develop months or even years after treatment.

This broader collection of long-term effects is sometimes referred to as pelvic radiation disease.

That’s why assessment matters.

Rather than treating every symptom in the same way, we need to understand what is actually happening:

  • Stool consistency
  • Frequency and clustering
  • Urgency
  • Rectal sensation
  • Tenesmus
  • Evacuation difficulties
  • Continence
  • Pelvic floor function
  • And, importantly, the impact on everyday life.

Management should be individualised and may involve dietary and medication optimisation, bowel retraining, pelvic floor rehabilitation, continence strategies and referral to appropriate specialist services.

And one important clinical message:

  • Rectal bleeding after pelvic radiotherapy shouldn’t automatically be assumed to be radiation proctitis.

It needs appropriate assessment, particularly to exclude other causes and, where relevant, recurrence of the original cancer.

Patients can feel embarrassed talking about bowel symptoms.

They may think nothing can be done.

Or they may simply have been told, ‘That’s just what happens after radiotherapy.’

But bowel function deserves to be part of the conversation

We need to ask.

We need to listen.

And we need to offer appropriate assessment and support.

For those working in oncology, colorectal care, gastroenterology or pelvic health – are we asking enough about bowel function as part of cancer survivorship care?”

Stay updated with Hemostasis Today.

Bowel dysfunction cancer colorectal care Gastroenterology Health Hematology Hemostasis Hemostasis News Hemostasis Today Medicine Oncology pelvic radiation disease pelvic radiotherapy Rebecca Embleton
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