questions to ask before bowel

Overview

Bowel cancer, also called colorectal cancer, is a disease where abnormal cells grow in the large intestine (colon) or rectum. It often starts as small growths called polyps, which can become cancerous over time. Finding and removing polyps early can prevent cancer.

Yes, bowel cancer is common. It affects about 1 in 20 people at some point in their lives. It is more common in older adults, but can occur at any age.

It mainly affects people over 50, but rates are increasing in younger adults. People with a family history of bowel cancer or certain inherited conditions have a higher risk. It affects men and women almost equally.

Symptoms

Common symptoms

• A change in your bowel habits that lasts for more than a few weeks, such as diarrhea or constipation
• Blood in your stool (poop) that may be bright red or dark
• Unexplained weight loss
• Feeling very tired all the time (fatigue)
• Pain or a lump in your tummy (abdomen)

Symptoms in children

• Bowel cancer is very rare in children. Symptoms in children are more likely due to other causes, but any persistent change in bowel habits or blood in stool should be checked by a doctor.

Symptoms in older adults

• Symptoms are often the same as in younger adults. Older adults may also have anemia (low red blood cells) that causes weakness and shortness of breath.

Causes

Main causes

• Bowel cancer usually starts from polyps in the colon or rectum. Over time, some polyps turn into cancer.
• Certain gene changes (mutations) can lead to cancer. Some are inherited, but most happen by chance.
• Lifestyle factors such as diet, smoking, and lack of exercise can increase risk.

Risk factors

• Age over 50
• A family history of bowel cancer or polyps
• A personal history of inflammatory bowel disease (like Crohn’s or ulcerative colitis)
• Smoking tobacco
• Drinking too much alcohol
• Eating a lot of red or processed meat
• Being overweight or not getting enough physical activity

When to see a doctor

See a doctor urgently if:

• If you have blood in your stool for the first time
• If your bowel habits change suddenly and last longer than 3 weeks
• If you have severe abdominal pain or vomiting

Book a routine appointment if:

• If you are due for bowel cancer screening based on your age and risk factors
• If you have a family history of bowel cancer and want to discuss screening earlier

Diagnosis

Your doctor will ask about your symptoms and medical history. They may do a physical exam, including checking your tummy and a rectal exam. If cancer is suspected, they will refer you for tests.

Tests that may be done

• Fecal immunochemical test (FIT) – checks for hidden blood in your stool
• Colonoscopy – a camera on a thin tube inserted into your bowel to look for polyps or cancer
• CT scan or MRI – imaging tests to see if cancer has spread

What to expect at your appointment

You may need to take laxatives to clean out your bowel before a colonoscopy. The procedure is done with sedation so you feel relaxed. If a polyp is found, it can often be removed during the test. Biopsy results take a few days.

Treatment

Treatment depends on the stage of the cancer and your overall health. Options include surgery, radiotherapy, chemotherapy, targeted therapy, or a combination. Your cancer team will create a personal plan.

Self-care at home

• Eat a balanced diet with plenty of fruits, vegetables, and whole grains
• Stay as active as you can, even during treatment
• Talk to your doctor about any side effects like pain or fatigue

Medical treatments

Surgery is often the main treatment to remove the cancer and nearby lymph nodes. If the cancer is early, it may be removed during a colonoscopy. Sometimes chemotherapy is given after surgery to kill any remaining cancer cells. Radiotherapy uses high-energy rays to destroy cancer cells, often for rectal cancer. Targeted therapies and immunotherapy are newer options for advanced cancer. Your doctor will explain the best options for you.

When is surgery considered?

Surgery is usually recommended if the cancer has not spread to other organs. In early stages, a small piece of the bowel may be removed. In later stages, more of the bowel may need to be removed, and you may have a temporary or permanent stoma (colostomy bag).

Living with this condition

After treatment, you may need time to recover. Many people return to normal activities, but some have ongoing changes in bowel habits or energy levels. Follow-up appointments and scans are important to watch for recurrence.

Lifestyle tips

• Eat smaller, more frequent meals if you have changes in appetite or digestion
• Drink plenty of water to stay hydrated
• Talk to a dietitian if you have trouble eating
• Get enough rest and listen to your body

Diet and exercise

A diet high in fiber may help prevent constipation but can be hard after surgery. Your doctor or dietitian can advise. Regular exercise, like walking, can improve energy and mood. Start slowly and build up as you feel able.

Mental health and emotional wellbeing

A cancer diagnosis can be very stressful and may cause anxiety or depression. It is normal to feel scared or sad. Talk to your doctor about support options, including counseling. If you feel overwhelmed, please reach out to a crisis helpline in your area.

Prevention

You cannot always prevent bowel cancer, but you can lower your risk. A healthy lifestyle can reduce your chances. Screening can find polyps before they become cancer, which is the best way to prevent bowel cancer.

Screening programmes

Screening is recommended for people aged 50 and older in many countries. Some areas start at 45. A simple stool test (FIT) is done every 1 or 2 years. If it is positive, a colonoscopy is needed. People with a strong family history may start screening earlier.

Complications

If left untreated

• Cancer can grow and spread to other parts of the body (metastasis), such as the liver or lungs
• Bowel obstruction (blockage) from a tumor
• Bleeding and anemia (low red blood cells)

Long-term outlook

Bowel cancer is very treatable, especially when found early. Many people are cured with surgery alone. Even if the cancer is advanced, treatments can control it for years. Your individual outlook depends on the stage and your overall health. Talk to your doctor about what to expect.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.