With “rapid transit” a major everyday problem, her GP prescribed Codeine Phosphate, utilising its constipating side effect. This relatively simple action fairly early in now in 1995, made a tremendous difference on its own, for which she was very grateful. If an attack is indicated, she stops the Codeine Phosphate until the blockage has passed, then recommences when confident it is safe to do so.

However, attacks of pain and vomiting were increasingly frequent by the later 1990's. So she felt that every avenue had to be explored, and with surgery ruled out, felt the time had come to draw a line under it and concentrate on management of the condition. 

She continues to see her consultant oncologist who treated her initially, and who has been so willing to suggest and prescribe medication to help manage the attacks and refer on as necessary. Dextromoramide was used for severe pain. Unfortunately this became unavailable, so Buprenorphine sublingual (Temgesic) was tried in Oct 2005. Buphenorphine is easy to take as it dissolves under the tongue, so no need for water when vomiting is likely or going on. But it was not nearly as good as Dextromoramide.

In 2001 Janice was referred, by her oncologist, to a gastroenterologist with a special interest in fibrosis resulting from radiotherapy. He carried out a series of tests and scans initially, so he knew exactly what he was dealing with. His suggestions included some interesting ideas, such as Hyperbaric Oxygen Treatment (HBO). Both HBO and a drug called Pentoxifylline help to reduce fibrosis and HBO for difficult to heal wounds. (see HBO page for more on HBO).

He was very keen for Janice to try these, but starting with antibiotics. If this was unsuccessful, Pentoxifylline, which is designed to improve blood flow to damaged areas and licensed for peripheral vascular disease and venous ulceration would be tried.

She did not opt for the Hyperbaric Oxygen Treatment for various reasons.

This therapy consists of having regular and repeated sessions breathing 100% oxygen in a recompression chamber at higher than atmospheric pressure. HBO is thought to be helpful for radiation injuries to soft tissue and bone.
Please go to our HBO page for more information and links.

Codiene Phosphate has been mentioned already and is very effective at slowing "rapid transit". It is purely for symptomatic relief and does nothing to reverse the damage of course.

Pentoxifylline (PTX) and alpha-tocopherol (vit-E) is different (see next section). It has been trialled and used in various centres. The links below give some more information on this regime.

Click here for the full text of an article describing the striking regression of radiotherapy damage in a clinical trial using PTX and vit-E from a source in Paris in 1999.

As the antibiotic treatment was ineffective, Janice started PTX + vit-E in February 2002. This had been shown to have a reversing effect on fibrosis following radiotherapy for breast cancer according to trials carried out by the Royal Marsden Hospital and others, though the effect on the bowel was unknown at this time. Initially it appeared to have no effect on Janice, indeed she was hospitalised with a series of attacks in July 2002 requiring rehydration, morphine and a gastric nasal tube.

Undeterred, she continued with PTX + vit-E, as she had been advised that the process of fibrosis reversal, if it was going to work at all, would be very slow. Until recently it had been thought that fibrosis was irreversible, but this not the case, as these drug trials, and other therapies such as hyperbaric oxygen have indicated. Janice had been free of these major attacks since July 2002, but unfortunately, Christmas 2002 was ruined by a prolonged attack, though not hospitalised.

Optimism remained, however, as the attacks had formerly been so frequent, so maybe the drugs were having the intended effect. There seemed to be no other reason for it. See Update page for times since 2002.