Patients with a past history of radiation therapy for prostate cancer or gynecologic malignancy can have lower GI bleeding as either an early or late complication of radiation damage. Acute radiation proctocolitis usually presents as transient diarrhea, tenesmus, and mucoid or bloody discharge per rectum. These signs and symptoms are usually resolved within days or weeks without specific therapy. Chronic radiation injury is an ischemic process, usually beginning 2 to 3 months after treatment has ended. Hemorrhage is the most common feature, ranging from occasional mild spotting to passing blood clots with every bowel movement.
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