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Spotting Bowel Cancer in Stool - Diagnosis and Treatment

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Bowel cancer or colorectal cancer can initiate in the small or large intestine. Read this article to know how it can be detected in a person's stools.

Medically reviewed by

Dr. Rajesh Gulati

Published At November 15, 2022
Reviewed AtFebruary 21, 2023

What Is Bowel Cancer?

Bowel cancer is a general medical term used to describe cancer that can initiate in the large bowel or large intestine. It can occur in any organ of the intestinal tract, including the small intestine, large intestine, or rectum. Normally, cancer describes a condition wherein the cells lining a particular organ grow out of control. Hence, when the cells of the colon or rectum proliferate rapidly, resulting in a condition known as colorectal or bowel cancer. The typical feature of bowel cancer is the presence of small and benign clusters of cells known as polyps. These polyps usually form on the inner part of the colon. The patient can have one or numerous polyps. The doctor usually recommends the patient undergo cancer screening tests to remove these polyps before they turn malignant (cancerous).

What Are Some of the Causes of Bowel Cancer?

The causes of bowel cancer are similar to other cancers and mainly occur due to rapid cell multiplication. These cells proliferate to form a mass known as a tumor. Nothing has been known about the exact etiology of bowel cancer. However, studies report that the factors mentioned below might increase the risk of bowel cancer:

  • Age - The risk of bowel cancer increases with a person's age. For example, nine out of ten individuals suffering from bowel cancer are above 60.

  • Family History- It has been observed that individuals who have a family history of bowel cancer are more likely to develop it. This is because genetic mutations or the presence of defective genes in the body increase the risk of bowel cancer. Patients who inherit these defective genes from their parents or close relatives can develop bowel cancer later in life. Such patients must consult the doctor or undergo genetic counseling to eliminate the risk of disease transmission.

  • Inflammatory Diseases - People with inflammatory intestinal conditions like inflammatory bowel disease, ulcerative colitis, or Crohn's disease are at a higher risk of developing bowel cancer.

  • Diet - Studies report that a patient's dietary habit significantly influences bowel cancer. For example, people consuming red or processed meat are more vulnerable to bowel cancer. However, a diet rich in fiber helps reduce the risk of bowel cancer.

  • Lifestyle - People with a sedentary lifestyle tend to develop bowel cancer more than the ones involved in physical activities.

  • Smoking - People who smoke daily are at a higher risk of developing colon cancer and heart diseases.

  • Alcohol - People who drink alcohol daily or frequently are at a higher risk of developing bowel cancer.

  • Obesity - Men who are overweight or obese can develop bowel cancer at a higher rate than the ones who maintain a healthy weight.

  • Digestive Conditions - Patients suffering from long-standing digestive disorders like Crohn's disease are more prone to developing bowel cancer. Patients with these conditions must consult the doctor at the earliest so they can be evaluated for other complications.

  • Genetic Disorders - Bowel cancer can occur due to the following genetic disorders:

    • Familial Adenomatous Polyposis - It is a condition that stimulates the formation of numerous polyps in the intestine.

    • Hereditary Non-Polyposis Colorectal Cancer - It is also known as Lynch syndrome and increases the risk of bowel cancer.

How Can Bowel Cancer Be Detected in Stools?

The symptoms of bowel cancer can be easily detected through alterations in the patient's bowel habits. The changes include frequent passing of stools, loose stools, and abdominal pain. However, diagnosing bowel cancer from stools can sometimes be challenging. For example, the presence of blood in the stools is a common symptom of bowel cancer and hemorrhoids. Similarly, the patient might have abdominal pain due to indigestion or after eating contaminated foods. However, the symptoms of bowel cancer get noticeable in patients above 60 years of age. These symptoms become significant when they persist or repeatedly occur after treatment. Hence, the following are the key symptoms for diagnosing bowel cancer in stools:

  • Change in bowel habits, including passing stools more frequently.

  • Loose stools.

  • Presence of blood in the stools, which is not associated with hemorrhoids (piles).

  • Abdominal pain, discomfort, and bloating usually occur soon after the person consumes something. As a result, the patient eats less, resulting in weight loss.

  • Diarrhea.

  • Persistent pain in the abdomen and while passing stools even after taking medications.

  • Weakness and fatigue.

How Is Bowel Cancer Diagnosed?

Sometimes, it becomes challenging to diagnose bowel cancer because the symptoms resemble many other medical conditions. However, the doctor usually asks about the patient's symptoms and whether he has a family history of bowel cancer. Next, the doctor examines the patient's abdomen and palpates the structures of the intestinal tract using the digital rectal examination. It is an effective method to check the presence of lumps or polyps in the abdomen or intestinal passage. However, digital rectal examinations can be embarrassing for some patients. Therefore, the patient might have to undergo the following tests if the digital rectal examination suggests that he has polyps or lumps:

  • Flexible Sigmoidoscopy - It is a procedure wherein the patient's rectum and a part of the large intestine are examined using an instrument known as the sigmoidoscope. It is a thin and long instrument that has a camera and light. The doctor inserts a sigmoidoscope into the patient's rectum up to the large intestine. The camera attached to the sigmoidoscope allows the doctor to visualize the bowel and take biopsies simultaneously.

  • Colonoscopy - It is a procedure where the entire large bowel or large intestine is examined using a device known as a colonoscopy. However, the patient must follow the dietary instructions given by the doctor because the bowel must be clear before the procedure. First, the doctor applies a numbing gel to the area and inserts a colonoscope into the rectum to examine the bowel. The camera attached to the colonoscope allows the doctor to view the images of the intestinal lining and the associated abnormalities.

  • CT (Computed Tomography) Colonography - CT colonography or visual colonoscopy involves using a CT scan to produce images of the intestinal tract. A tube is inserted into the rectum to inflate the bowel with gas during the procedure. Next, the CT scans are taken from different angulations. It is one of the most effective procedures to identify potentially cancerous sites.

What Are the Different Stages or Grades of Cancer?

Staging or grading of cancer is done after diagnosis to frame a treatment plan. The different grades of bowel cancer are listed below:

  • Grade 1 - Cancer shows slow growth and does not spread beyond the bowel.

  • Grade 2 - Cancer shows moderate growth and can spread beyond the bowel.

  • Grade 3 - Cancer shows rapid growth and spreads beyond the bowel.

How Is Bowel Cancer Treated?

The treatment of bowel cancer depends upon its severity. For example, the doctor might recommend local excision if the cancer is in the early stage. It is a procedure wherein a small part of the intestinal lining is removed. However, if cancer spreads into the muscles surrounding the colon, the doctor might recommend the removal of a part of the colon through a procedure known as a colectomy. The two ways by which colectomy can be performed are listed below:

  • Open Colectomy - It is a procedure wherein the doctor makes a tiny cut to remove a part of the colon.

  • Laparoscopic Colectomy - In this procedure, several small cuts or incisions are made in the abdomen. Next, the doctor inserts a small instrument that has a camera. It allows the doctor to view the intestinal lining. Sometimes, the nearby lymph nodes are also removed surgically.

The other methods by which bowel cancer can be treated are listed below:

  • Chemotherapy - A procedure wherein powerful drugs are used to kill cancer cells.

  • Radiation Therapy - High-intensity radiation is used to kill cancer cells in this condition.

  • Biological Treatments - The newly discovered medications listed below target the specific proteins which are located on the surface of cancer cells. They are known as epidermal growth factor receptors:

    • Cetuximab.

    • Bevacizumab.

    • Panitumumab.

How to Prevent Bowel Cancer?

Patients whose family members are diagnosed with bowel cancer are bound to suffer from the same. However, the following factors help prevent bowel cancer:

  1. Avoid junk foods, street food, red meat, and processed or deep-fried foods.

  2. Consume a fiber-rich diet, vegetables, and fruits.

  3. The patient must exercise regularly and engage in physical activities like walking or cycling.

  4. Maintain a healthy weight.

  5. Avoid smoking or excess alcohol consumption.

  6. Undergo screening tests at regular intervals to prevent the risk of bowel cancer.

Conclusion

Bowel or colorectal cancer is a common condition that affects people above 50. The signs of bowel cancer can be detected through the patient's bowel habits. Hence, the patient must remain careful and note all the symptoms and the changes in bowel habits. In addition, the patient can consult a doctor to learn more about the management of bowel cancer.

Dr. Rajesh Gulati
Dr. Rajesh Gulati

Family Physician

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colorectal cancer
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