Bowel Disease: Patient Fact Sheet

Bowel disorders are conditions that often affect your small intestine. Some of them can also affect other parts of your digestive system, such as your large intestine. Bowel disorders affect how your body digests and absorbs food. They can cause uncomfortable symptoms, such as diarrhoea or constipation.

There are various types and causes for bowel diseases and reasons why people get these diseases. 

Below is a list of Bowel Diseases:

• Colonic Polyps
• Bowel Cancer
• Crohn's Disease
• Diverticulosis and Diverticulitis
• Intestinal Obstruction
• Irritable Bowel Syndrome
• Ulcerative Colitis

What Are the Symptoms of Bowel Disease?

• Abdominal cramps and pain
• Diarrhoea that may be bloody
• Severe urgency to have a bowel movement
• Fever
• Weight loss
• Loss of appetite
• Iron deficiency anaemia due to blood loss

About Bowel Cancer  

Bowel cancer, also known as colorectal cancer, develops from the inner lining of the bowel and is usually preceded by growths called polyps, which may become invasive cancer if undetected. Depending on where the cancer begins, bowel cancer may be called colon or rectal cancer. Bowel cancer is the third most common type of newly diagnosed cancer in Australia.
 
15,325 Australians are told they have bowel cancer each year (296 a week), including 1,531 people under the age of 50.  Bowel cancer claims the lives of 5,336 Australians every year (103 a week), including 272 people under the age of 50 years.

What causes Bowel Cancer?

Several lifestyle factors can increase your risk of bowel cancer:

• Eating too much processed meat (for example, bacon, ham, salami, sausages)
• Eating too much red meat (for example, beef, lamb, pork)
• Drinking too much alcohol, especially if you drink more than two standard drinks per day
• Unhealthy weight (being overweight or obese)
• Smoking, especially if you smoke more than 2 packs a day
• Not enough physical activity

Other factors that cannot be changed may also increase your chances of bowel cancer, including:

• Age: From age 50, your risk increases
• Family history: around 3 in 10 cases of bowel cancer have a strong family link. The more family members affected by bowel cancer, and the younger they were when diagnosed, the more likely it is that you will also develop bowel cancer
• Genetic mutations: Up to 1 in 10 cases of bowel cancer are due to rare genetic mutations which may cause hundreds of polyps to grow in your large bowel (familial adenomatous polyposis, MYH-associated polyposis)
• Inflammatory bowel disease (IBD): People with Crohn’s disease and ulcerative colitis have a higher risk of developing bowel cancer over time, and experience similar symptoms

Bowel cancer symptoms

• Change in bowel habit including diarrhoea, constipation, or the feeling of incomplete emptying
• A change in the appearance or consistency of bowel movements such as thin bowel stools
• Blood in the stools, colour seems different
• Abdominal pain, bloating or cramping
• Anal or rectal pain
• A lump in the anus or rectum
• Weight loss
• Unexpected tiredness or fatigue

When should I see my doctor?

See your doctor if you have blood in your stool, unexplained changes in your bowel habits, tiredness, abdominal pain, or any other symptoms that may indicate bowel cancer.

Since bowel cancer can develop with few signs early on, you should also speak with your doctor if you know of any pre-existing risk factors, or if you are concerned about getting it later in life.  Your Doctor may refer you to a Gastroenterologist or to see a Colorectal Specialist.

What is a colorectal surgeon?

A colorectal surgeon is a surgeon who specialises in the management of disorders of the small bowel, colon, rectum and anus. This includes both benign (non-cancerous) and malignant (cancerous) problems such as:

• Colorectal cancer and polyps
• Inflammatory bowel disease including Crohn’s disease and ulcerative colitis
• Diverticular disease of the colon
• Anorectal conditions including haemorrhoids, fissures, abscesses and fistulas
• Pelvic floor disorders including bowel prolapse
• Functional bowel problems such as constipation and incontinence

In particular colorectal surgeons have been specifically trained in the diagnosis and treatment of rectal cancer. Rectal cancer treatment requires special investigations prior to surgery and specialised skills to remove the rectum. Colorectal surgeons have additional experience in this type of surgery. 

How is bowel cancer diagnosed?

If you are experiencing symptoms or return a positive test from bowel cancer screening, the following tests to confirm or rule out bowel cancer will be done. 

• A physical examination
• Blood tests for anaemia
• A colonoscopy or sigmoidoscopy to see inside your colon, rectum and anal canal
• Imaging scans of your bowel such as a barium enema (a colon x-ray), CT or MRI scan
• A biopsy to take a sample of tissue from your bowel wall.
• A chest x-ray to see whether the cancer has spread to your lungs
• A lymph node biopsy
• An ultrasound

Treatment for Bowel Cancer

The main treatments for Bowel Cancer is surgery – the cancerous section of bowel is removed; it is the most effective way of curing bowel cancer, and is all that many people need. Additional treatments are chemotherapy, where medication is used to kill cancer cells and radiotherapy, where radiation is used to kill cancer cells.

If colon cancer is at a very early stage, it may be possible to remove just a small piece of the lining of the colon wall, known as local excision. If the cancer spreads into muscles surrounding the colon, it is usually necessary to remove an entire section of your colon, known as a colectomy.

Treatment for bowel cancer is decided according to:

• Where the cancer is in your bowel
• How big the tumour is
• The number, size and position of any tumours outside the bowel (including lymph nodes)
• The type of cancer cells – their cell type and genetic makeup
• Your general health and fitness

You can lower your risk of Bowel Cancer

While no cancer is completely preventable, you can lower your risk of bowel cancer by:

• Screening every two years to help detect bowel changes early when they are easier to treat
• Eating a healthy diet (limit red meat, avoid processed meat, eat more grains, vegetables, fruit, & beans. Avoiding high calorie foods and sugary drinks)
• Being physically active for at least 30 minutes every day and sitting less
• Reducing the amount of alcohol you drink 
• Stopping smoking