Q. Are persistent left-sided stomach pains with constipation or diarrhea signs of colon cancer?

Answered by
Dr. Ajeet Kumar
and medically reviewed by Dr. Preetha J
This is a premium question & answer published on Sep 25, 2020 and last reviewed on: Sep 30, 2020

Hi doctor,

Here are my symptoms: I would associate chronic dull left side pain for years with my endometriosis, so I did not think much of it.

I have normal stools on some days mixed with constipation and diarrhea on other days. I am taking Vesicare, which causes constipation, and contributed to my symptoms to the medication, and dehydration at times.

I have not noticed any blood in my stool. My stools look ordinary at times, but also look different on the days I have diarrhea or constipation as expected.

I have an appointment with my general practitioner in three weeks. Given the recent awareness nationally regarding colon cancer, do you think it is fine for me to wait for my appointment? I am not in any distress. I guess I am just having some anxiety as I never considered colon cancer as a potential diagnosis, given my symptoms. If anything, I thought I might have IBS.

Can you provide any insight into the difference between colon cancer versus IBS?

Do most patients experience bloody or dark stools when having colon cancer?




Welcome to

Well, the IBS (irritable bowel syndrome) and colorectal carcinoma are two extremes of the spectrum of the GI (gastrointestinal) diseases. The former is functional non-serious, while the latter is a severe condition.

However, it is not only the type of symptoms, which may be similar in both at the start (all colon-rectal cancer do not bleed initially at the time of their identification). Duration and progression of the symptoms over time are the two other essential components to be considered before diagnosing both conditions.

IBS tends to remain for years, and do not cause bleeding, weight loss, and decreased appetite. These are all alarming symptoms, which are frequently present in a patient with colorectal cancers.

Since you do not have any alarming features, I do not think you should be worried about this much. IBS can have a change in stool form, altered bowel habits, and pain in the abdomen which decreases after passing gas or stools. In contrast to colorectal cancer, the problem is often severe, with episodes of complete obstruction (unable to pass wind) and grossly distorted stools with bleeding.

I hope you would find this explanation helpful.

Should I tell you how to approach further, I would want you to tell me the following things.

  • Did you lose any weight?
  • Any family history of abdominal cancer?
  • Do you smoke or take alcohol?
  • Does this pain resolve after you pass stools?
  • Do you feel this discomfort or pain in the middle of the night?

Let me know the above.

Best regards.

Hello doctor,

Thanks for an informative response.

I have not lost weight, actually gained during COVID-19 quarantine. My pain comes and goes, but I feel it gets better with exercise and bowel movements sometimes. However, I do have this dull pain on my left side that has been present for years, so I think I have just gotten used to it, and it is more intense at this time due to anxiety. I do not smoke, and I drink socially. I must admit I have had more alcohol this summer than usual, so maybe this is contributing to my symptoms as well. No discomfort at night. Does it seem non-urgent? Should I monitor and see what my GP says? Thank you so much.



Welcome back to

Yes, it seems entirely non-serious. You should monitor and wait till you meet your GP. Well, let me tell you that you have already met a gastroenterologist by now before meeting your GP. How easy was that, right? Current guidelines of the American College of Gastroenterology say that anyone at the age of 50 should have a colonoscopy screening. Of course, it is a younger age when someone has a risk or tendency towards colon cancers. The risk individuals who have a propensity towards developing colon cancer are those: 1. One of their first-degree relatives has colon cancer at age less than 60 years.

2. Or two first-degree relatives with colorectal cancer irrespective of age at their diagnoses.

3. Three family members (spanning over first and second degree) with colon cancer with one before the age of 60.

4. Genetic cancer syndrome associated tumor in a first-degree relative.

I have written as far as I recall. You may find some variation on the original file on the internet. But this is generally the approach that assesses the risk of an individual for colon-rectal cancer based on family history. So none such history is present in you, nor any alarming signs, so you should relax now. For IBS, you can use tablet Mebeverine 200 mg twice daily. This is an antispasmodic medication that relaxes the muscles of the gut and hence relieves pain. I hope this explanation served the purpose. Best regards.

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