#2 How to be a better patient – recognising alarm symptoms

One of the most shocking moments during my first internship in the hospital was when I had to examine an old lady with a suspicion of having bowel cancer (also called colorectal cancer). She has had blood in her stool for the past few months. Lately she had pain during defecation and therefore went to the GP. After rectal examination, it was clear she had bowel cancer. She was referred to the department of internal medicine where I was interning. The bowel cancer grew through her bowel wall into other organs. It was clear that the cancer had been growing for a while, because of the late stage cancer and her frailty, there were no curative treatment options. It’s impossible to exactly know what her chances of survival would have been if she had sounded the alarm earlier, nevertheless it’s almost certain that her chances of curative treatment options would have been larger if the cancer was discovered earlier.

Doctors are trained to pick up alarm symptoms. In medicine these are called “red flags“. These are symptoms that indicate the patient might be having a life-threatening or life-altering disease that needs urgent medical attention. In this post I want to share the alarm symptoms for bowel cancer. According to UK statistics, 1 in 15 UK males and 1 in 18 UK females will be diagnosed with bowel cancer in their lifetime. 54% of bowel cancer cases in the UK are preventable (let’s discuss prevention tomorrow). In short, there’s a large chance you, a friend or a family member will get bowel cancer, so it’s good to be aware of the main alarm symptoms for bowel cancer:

  • Unintended weight loss: it’s hard to say exactly how much weight is worrisome. Usually a few kilograms (around 4 or more kg) weight loss becomes a bit suspicious, but it also depends on your baseline weight.
  • An inexplicable sustained change in your stool, such as regular episodes of constipation, diarrhea, or narrowing of the stool, that lasts for more than a few days
  • Having a constant sensation you need to poo despite recently having done a number two
  • Rectal bleeding: immediately alert your doctor if you have had this, even if it has just been 1 episode. There are several causes of rectal bleeding and let your doctor examine whether it’s cancer, haemorrhoids or something else.
  • Black or very (unusual) dark brown stool: this could be an indication of blood in your stool. Usually blood in the stool is even more smelly than a regular poo…
  • Unusual prolonged cramping or belly pain

Some countries provide a national bowel cancer screening programme. If you’re lucky enough for this taking place in your country, it’s important to participate. In this way you increase your chances of detecting or even preventing cancer at an early stage, increasing chances of getting curative treatments.

Let me know if I’ve missed any important alarm symptoms. I’d love to hear from you.

Credits to image creator: Anatomy vector created by brgfx – www.freepik.com

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