Dr Phil: Bowel cancer (video)
Hello there, I’m Dr Phil, and today we’re going to be talking about bowel cancer ... Now, we Brits are very good at talking about our bowels in a humorous fashion, but perhaps not talking about bowel cancer. 35,000 people a year are diagnosed with bowel cancer, it’s the second most common cancer in women and the third most common cancer in blokes. So clearly important.
Your food comes in through your gullet or oesophagus, in through your stomach, out through your duodenum and small intestine, eventually ending up in the colon, which is almost like a U-shape: you have an ascending colon, a transverse colon and a descending colon. It comes out through your descending colon and out through your rectum and anus. Now, bowel cancer usually starts as a little polyp poking in on the side of the tube, and, as you can imagine with a little fleshy polyp, it can bleed.
Depending on how low down it is depends on the colour of the blood that comes out. If it’s very low down it will be fresh red blood that you might notice mixed in with your poo. Often that’s due to haemorrhoids (piles) if it’s just blood on its own, but DON'T ASSUME THAT ANY RECTAL BLEEDING IS DUE TO PILES – ALWAYS GET IT CHECKED OUT. The older you are the more likely you are to have cancer, so particularly if you’re elderly you must get that checked out.
If the bleeding happens a little bit higher up, often the blood gets worked on by the digestive juices as it passes through and it comes out a bit darker. If the bleeding is from very high up around about the stomach, it comes out as something called melena, which is black and tarry and the most disgusting smell you’ve ever smelt in your life. That is both a social and a medical emergency.
A lot of people may get a bit of bleeding. Also with a polyp, it can narrow the hole in your tube so you might find that your bowel habit is altered: you might find that you get constipated when you weren’t usually constipated or you get fluctuating bouts of constipation and diarrhoea. Any significant change in your bowel habit also needs checking out. You may find you pass a little bit of mucus, which isn’t normal, and you may find lower down that you want to pass something but nothing comes out. That may be because you’re trying to pass the polyp and it won’t come out, so all these symptoms need to be taken seriously.
Some people have a polyp that just bleeds very slowly, so they get a bit anaemic and tired. You may get pain in your abdomen or you may notice a little lump or just feel generally knackered. Particularly if you have a family history of bowel cancer it’s worth getting checked out. If you’re 60 to 69, the UK's NHS has a bowel cancer screening program, which involves taking faecal occult bloods, a fancy name for taking a bit of poo, smearing it on a card and seeing if there’s any blood in it. If there is, the next step will be to have a look up your bowel, often with a sigmoidoscope which goes a little bit up into the sigmoid colon (the floppy bit at the bottom) or they may put a colonoscope up there which goes all the way up. If you want to know more about colonoscopes, put ‘Billy Connelly colonoscope’ into YouTube – there’s a very informative discussion on it. If you want to know more about embarrassing problems in a humorous way I would recommend Sex, Sleep or Scrabble, or visit www.drphilhammond.com.
Dr Phil Hammond is a medical doctor, comedian and commentator on health issues.
Written by: Dr Phil Hammond
Edited by: Dr Phil Hammond
Last updated: Tuesday, April 29th 2014
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