Going for a walk, shopping or sitting down for a meal can become a concern when you need a toilet nearby. If these problems start after pelvic radiotherapy, they deserve assessment, even when cancer treatment ended some time ago.

Radiation proctitis is one possible cause. Hyperbaric oxygen may be considered in selected chronic cases, but the first step is to establish what is causing the symptoms and which treatment is appropriate.

What is radiation proctitis?

Also called radiation proctopathy, it is injury to the rectum associated with pelvic radiotherapy. The rectum is the final part of the large intestine. Symptoms may develop during or soon after treatment, while chronic forms can appear months or years later, according to the US National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

It differs from radiation cystitis, which affects the bladder. Describing whether symptoms involve the bowel, urinary system or both helps guide the consultation.

Which symptoms should you discuss?

The NIDDK describes symptoms including:

  • Bowel urgency or a persistent need to open your bowels even when they may be empty.
  • Blood or mucus when passing stool.
  • Diarrhoea, constipation, or rectal or abdominal pain.

Symptoms alone cannot establish this diagnosis. Seek medical advice for rectal bleeding rather than assuming radiotherapy is responsible. Heavy or continuous bleeding requires emergency care. Severe abdominal pain also needs immediate medical attention; do not wait for a hyperbaric appointment.

First, establish the cause

The British Society of Gastroenterology's 2025 guidance stresses that bleeding after radiotherapy needs investigation because other causes are possible. Your specialist may arrange endoscopic or imaging tests. Previous radiotherapy does not remove the need to investigate a new symptom.

Explain more than how much bleeding you notice. Tell the specialist whether urgency prevents you from going out, whether you have pain and how your habits have changed. This helps describe the impact on everyday life.

Where does hyperbaric oxygen fit into treatment?

Treatment depends on the cause, symptom severity and test findings. NIDDK information describes options ranging from medicines to endoscopic procedures for certain types of bleeding. Different people may need different approaches.

Hyperbaric oxygen therapy involves breathing oxygen in a pressurised chamber. The American Society of Colon and Rectal Surgeons' 2018 guideline includes it as an option for reducing bleeding in chronic radiation proctitis. Its use should be assessed within your medical care plan, with specialist follow-up.

What does the evidence show?

Research findings are not consistent. The British society's 2025 guidance describes trials with favourable outcomes alongside others without a significant benefit over sham treatment.

The HOT2 trial, published in 2016, found no significant benefit in its main outcomes for chronic bowel symptoms after pelvic radiotherapy, including patients with rectal bleeding. Hyperbaric oxygen therefore cannot be presented as a guaranteed solution to any bowel problem after radiotherapy.

A useful question is: “Given my diagnosis, tests and previous treatments, what benefit is reasonable to expect, and how will we assess it?” No one can promise that every symptom will disappear or specify a treatment course suitable for everyone.

Preparing for an assessment

Gather the documents you already have and ask which ones the team needs:

  • Radiotherapy reports and reports from the specialist managing your bowel symptoms.
  • Recent tests, previous treatments and how you responded.
  • Your current medication list and relevant medical history.
  • Questions about risks, visit duration, reviews and costs.

Do not stop medicines on your own. If hyperbaric treatment is proposed, mention ear discomfort with pressure changes or anxiety in enclosed spaces. Ear problems and temporary visual changes are among the possible adverse effects; the team should explain risks and assess your circumstances first.

The FDA highlights staff training and supervision during treatment. Check instructions about clothing and permitted items. Our first-session guide helps you prepare your questions.

Discussing your case at HMCE Estepona

If you have diagnosed radiation proctitis or your specialist has suggested hyperbaric oxygen, you can request an assessment at HMCE. The team reviews your situation and explains whether this option fits into your care.

Healthcare professionals support you before, during and after each session, with supervision and the ability to communicate with staff during treatment. Appointments take place at Avenida de España, 242, Estepona, including for people travelling from Marbella and elsewhere on the Costa del Sol.

Call 952 80 67 96 to ask which documents to prepare, or read about assessment of radiation-related injuries.

Frequently asked questions

Can it start long after radiotherapy ends?

Yes. Some late injuries develop months or years later. Mention previous radiotherapy without assuming it explains the symptoms.

Are radiation cystitis and proctitis the same?

No. Cystitis affects the bladder; proctitis affects the rectum. Assessment needs to address the symptoms and organ involved.

Does hyperbaric oxygen replace cancer or digestive follow-up?

No. In this context it is considered for selected radiation-related injuries, not as a cancer treatment. Continue follow-up with your specialists.

Sources consulted: NIDDK patient information on proctitis; American Society of Colon and Rectal Surgeons, 2018 guideline; British Society of Gastroenterology, 2025 guidance; HOT2 trial, The Lancet Oncology, 2016; NHS information on rectal bleeding; FDA hyperbaric oxygen safety guidance. This article is for information and does not replace individual diagnosis or prescribing.