When ‘just digestive issues’ become dangerous: Doctors on bowel cancer signs

With today’s fast-paced lifestyle, digestive issues like bloating, acid reflux, stomach cramps and constipation are often neglected due to stress, unhealthy eating habits, fatigue and junk food consumption. Most people rely on over-the-counter remedies or home treatments, assuming the symptoms are temporary. But doctors are now sounding the alarm that persistent gastrointestinal issues can sometimes indicate something more serious: bowel cancer.

Specialists say one of the biggest hurdles in treatment is that bowel cancer is often diagnosed late, even as cases continue to rise among younger adults. Patients usually consult doctors only when the disease has reached an advanced stage, as early symptoms are often mistaken for common gastric disorders or irritable bowel syndrome (IBS).

According to Dr Deepak Chhabra, Senior Gastrointestinal Cancer Surgeon at L H Hiranandani Hospital, Powai, Mumbai, “Any change in bowel habits lasting more than two or three weeks, unexplained weight loss, blood in the stool or anaemia can be warning signs of bowel cancer.”

The doctor says some level of digestive discomfort is normal, but persistent, frequently recurring or progressively worsening symptoms should be evaluated. These may include constant bloating, abdominal distension that comes and goes, unexplained cramps, ongoing constipation, an increased number of loose stools associated with cramping, or sudden changes in bowel habits.

Another major red flag is blood in the stool, which may appear bright red, dark red or black. Fatigue caused by iron-deficiency anaemia can also signal internal bleeding from the bowel. Some patients may develop pencil-thin stools, feel that bowel movements are incomplete, or experience a sudden urgency to use the restroom.

One reason bowel cancer is frequently diagnosed late is that its symptoms mimic those of more common digestive disorders.

“Often, patients dismiss bloating and abdominal discomfort as acidity, gas, indigestion or food sensitivity. Low-grade symptoms such as cramps, constipation, diarrhoea and bloating are also common in IBS (irritable bowel syndrome), which leads many individuals to self-medicate without proper evaluation,” says Dr Chhabra.

“Many people delay colonoscopy because of fear, embarrassment or the belief that their symptoms are temporary,” says Dr Chhabra. However, postponing the test can significantly reduce the chances of early detection.

He says colonoscopy is key to the early detection of bowel cancer, when treatment is usually more effective and less aggressive. It can also identify precancerous polyps, which can be removed before they develop into cancer.

Bowel cancer is no longer considered a disease that affects only older adults. Doctors are increasingly diagnosing patients under the age of 50, including those with no family history of the disease.

Dr Chhabra says several aspects of modern lifestyles may be contributing to the rise, including sedentary routines, obesity, highly processed diets, alcohol consumption, lack of physical activity and exposure to harmful environmental substances.

Dr Sharma lists several red flags that require medical attention, including persistent constipation or diarrhoea, changes in bowel habits lasting more than six weeks, and discomfort during bowel movements.

“Fatigue and anaemia can sometimes be the only visible signs of chronic internal bleeding from an early-stage tumour,” he says, adding that colonoscopy remains one of the most effective tools for early detection because it allows doctors to examine the bowel, identify abnormal growths and, if necessary, perform a biopsy.

He cautions against delaying colonoscopy after a positive stool test, saying that even a delay of a few months can allow a treatable lump to develop into an aggressive cancer.

Experts stress that persistent digestive symptoms should never be ignored simply because they seem common. While most stomach problems are benign, symptoms such as persistent discomfort, changes in the nature of pain, unintentional weight loss, iron-deficiency anaemia and blood mixed with stool should prompt immediate medical evaluation.

(The author, Nivedita, is a freelance writer. She writes on health and travel.)