There is a persistent taboo surrounding discussing bowel movements, but it is hindering vital conversations with doctors that are essential for the early detection of serious health issues. Bowel cancer remains one of the most common cancers across the UK, yet public understanding of its symptoms and crucial screening procedures frequently lags. Mr Jeremy Clark, a consultant general surgeon specialising in colorectal diseases at Nuffield Health in Brighton, has underscored five critical warning signs the public must recognise.
1. Blood in the stool
“Passing blood when you go to the toilet is a worrying feature that you should flag to your GP,” says Clark. The surgeon highlights how the colour can vary from bright red to almost black. “If you’re bleeding from the beginning of your colon, it has to travel three or four feet before it comes out with your waste material, so it will turn very dark black. But if you’re bleeding from something lower down in the bowel, closer to your bottom, it will come out bright red,” he explains. “If you see blood in the stools, particularly darker-coloured blood or blood that’s actually mixed in with the stools, just once and it’s significant, that should be reported to your doctor straight away. Don’t wait for that to keep on happening.” Persistent bright red blood should also not be ignored. “If you see a bit of bright red blood on the toilet paper after going to the toilet and you know you have got haemorrhoids then that’s not so worrying,” says Clark. “However, if it carries on for longer than a week then that should be reported to your doctor if it has never been investigated before.”
2. Changes in bowel habits
“If your bowels go from working once a day like clockwork, and then suddenly you’re going two or three times a day and the bowels are a bit looser, that’s something that needs to be looked into,” says Clark. “Becoming more constipated isn’t so much of a risk factor, but if it’s a sudden change and it doesn’t go back to normal, that needs to be looked at as well. If your bowels play up for just a day or two and then settle, there shouldn’t be anything to worry about. But if you have a persistent change that goes on for a couple of weeks, then that should be reported.”
3. Abdominal pain
“Bowel cancers can cause abdominal pain,” highlights Clark. “This tends to be a later feature, but it can occur early on, too.”
4. Bloatedness
“People often feel quite bloated if there’s something wrong going on in the bowel,” adds Clark.
5. Unexplained weight loss
“Bowel cancers can cause you to lose weight by having an impact on how your digestion is working,” notes Clark.
Why do many people ignore these symptoms?
“There’s a whole host of symptoms, but the problem is that they all cross over with other less serious problems, such as haemorrhoids or irritable bowel syndrome (IBS), so people often ignore or easily dismiss these symptoms,” recognises Clark. Reporting any unusual changes or incidents as early as possible is a critical factor in improving treatment outcomes and overall prognosis. “We don’t want people to be sitting on symptoms for a couple of months, wondering if something is going to change back to normal, because although bowel cancers usually do progress slowly, occasionally they can be more aggressive,” says Clark. “We like people to report these things early, as we would rather investigate something and figure out that it’s nothing rather than be looking at things later on and not being able to do so much.”
What should people do if they have symptoms and are concerned?
If you have any of these symptoms, or if you’re worried about any changes that you notice, visit your GP. “GPs will often give patients a FIT kit (Faecal Immunochemical Test), which comes with all the instructions. Basically, an at-home kit to collect a small sample of your faeces that then goes off to the laboratory to be tested,” explains Clark. You’ll usually get a letter telling you the results within two weeks of sending your sample, according to the NHS website. People aged between 50 to 74 are also offered FIT kits every two years, regardless of their symptoms, as part of the national bowel cancer screening programme. “If it comes back as positive, that means there is blood in your stools which needs to be investigated,” says Clark. “You will be referred into your local unit to have a conversation with the team about having either a colonoscopy or a CT scan to check and make sure that there is nothing going wrong in your bowel and [there are] no signs of polyps or bowel cancer. By doing that we pick things up much earlier and they become much more treatable and curable.”
