Treatment Side Effects - Bowel Problems

Common bowel problems experienced by men with prostate cancer include the following:

• Diarrhea
• Constipation
• Bowel leakage (incontinence)
• Increased flatulence
• Rectal bleeding
• Increase in the urgency or frequency of bowel movements¹

While none of these symptoms are directly life-threatening, they do have the potential to substantially affect a man’s quality of life. It is possible for one man not to feel impacted by his bowel problems, while another may experience debilitating quality of life changes. Whatever way you process or manage any bowel-related issues you experience is normal.

How do bowel problems develop?

Bowel problems related to prostate cancer or its treatment can be difficult to predict. Occasionally, a tumor in the prostate may grow and start pressing on other nearby structures in the pelvis, producing bowel-related issues. Other times, these issues can be a sign of advanced prostate cancer that has metastasized to the spine. In this situation, cancerous tumors can destroy spinal bones and disrupt or damage the nerves in the spinal cord that control bowel functioning. Another way these symptoms can develop is as a result of prostate cancer treatment, such as radiation therapy, surgery, or chemotherapy.

How long do they last?

Just as the ways to develop urinary or bowel incontinence are numerous, so are their potential outcomes. In many instances, bowel problems related to prostate cancer treatment may resolve on their own, as an individual is recovering from the treatment. In other cases, these effects may be longer-lasting, or even permanent. Your doctor will help determine what the underlying cause of your bowel problems may be, and can help predict how long these issues may last and how you can best manage them.^1-3

Managing constipation, diarrhea, and other bowel problems

In some instances, normal bowel functioning and control will be regained after treatment and post-recovery. But if this process isn’t occurring as fast as anticipated, or isn’t happening at all, there are a few interventions and lifestyle changes that can help manage bowel problems. Several of these options include:

• Anti-diarrheal agents (immodium, lomotil)
• Eating a well balanced diet with fiber
• Pelvic floor muscle exercises
• Absorbent and/or scented pads
• Avoiding foods that may irritate the digestive system
• Creating a bowel movement schedule and retraining your bowels
• Decreasing physical activity after meals

In rare instances, it may be possible to have surgery for bowel incontinence, including anal sphincteroplasty or anal sphincter repair, depending on the predicted underlying cause of the incontinence.^1-3 Treating bowel-related difficulties can be tricky, and will largely depend on the exact symptoms you are experiencing.

Talking about bowel problems with your doctor

Bowel problems can be embarrassing and life changing. Because of this, it’s common for men to avoid talking about these struggles with their healthcare team or partners. By not talking about these issues, feelings of fear or inadequacy may build up and cause significant mental, emotional, or physical complications.

For this reason, it is critical to talk with your doctor about potential treatment options that may be right for you, or for specific tips on how to manage what is going on. How much you share about your bowel struggles is completely up to you, however, enlisting the support of an intimate partner, spouse, or close confidant may help ease the burden and set expectations or plans to be followed in the event that you need help managing your bowel struggles outside of your home.