LIKE grey hair and wrinkles, constipation is something many people have experienced. It is a very common complaint; mild irregularity in the passing stool is probably even more prevalent.
Constipation is typically a condition of infrequent bowel movements — typically fewer than three bowel movements a week — and difficult passage of stools which does not go away. Howbeit, it could be more than just an irritant. Left untreated, constipation can leave some uncomfortable and lasting reminders.
“Many times, what many people call pile or haemorrhoid could also be an indication for cancer and many people overlook it,” said Dr Adewale Adisa, consultant general surgeon, Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile Ife, Osun State.
According to Dr Adisa, “If somebody, for instance, has cancer in the colon, the pressure that builds up will make the faeces to become hard. And when it is coming out, it will brush the anus and bleeding will occur.
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“Meanwhile they will be treating the pile locally without taking care of the cause of the pile. Haemorrhoid can bleed, but more than half of the patients that come to our hospital with bleeding do so from colon cancer.”
Colon cancer, also sometimes called colorectal cancer, usually starts out as a noncancerous growth called a polyp inside the inner lining of the colon, also known as the large intestine and a major component of the digestive tract.
Polyps form for a variety of reasons related to genetics, not eating enough fibre, eating a diet high in red meat and other risk factors. Once the polyp turns into cancer, the slow growth of the tumour often affects bowel habits, which can produce symptoms such as constipation.
Together, the colon and the rectum form the large intestine, a long tube that extracts nutrients from mostly digested food and moves waste products to the anus for excretion.
Much as several things, including poor intake of water, a diet poor in fibre, highly spicy foods, sedentary living and certain medications can predispose to constipation Dr Adisa stated that some medical conditions too can contribute to persisting constipation.
According to him, “people should stop assuming that any blood in the stool or bleeding from the anus is due to pile and resort to using herbal preparations.
“That is why many people that have colon cancer end up dying because they have been sitting down at home calling it jedijedi or pile, but it is not jedijedi.
“Bleeding from haemorrhoid can mimic the bleeding of cancer. Anybody that sees blood should ensure they rule out cancer before they take it as an ordinary haemorrhoid,” he declared.
Dr Adisa said that visual examinations such as a colonoscopy can be performed to be sure that there is no cancer in the colon.
The American Cancer Society guidelines recommend adults aged 45 and above with an average risk of colorectal cancer should undergo regular screening which can include stool-based tests or visual examinations such as a colonoscopy or CT colonography. During a colonoscopy, a scope, a tube with a small camera on the end is passed into the colon to have a look.
The frequency of screenings varies for each test. It also varies based on the risk level of the individual. Individuals with a family history of colon cancer are two to three times more likely to develop colon cancer in their lifetime.
The signs and symptoms of colorectal cancer depend on the location of cancer, how advanced it is and how it affects the organs and tissue. Aside from constipation, other common colon cancer symptoms include unexplained or unintentional weight loss and anaemia.
Others include unexplained fatigue, stomach discomfort, a change in bowel habits or blood in the toilet after defecating and change in the appearance of the stool, or dark / black-coloured stools.
The way that the stool looks can be a good indicator of what is going on inside the body. The small, hard stool is an indicator of constipation. A healthy stool should be a medium brown; it should be soft but not liquid.
It should be easy to expel so the individual dozes not have to strain and it shouldn’t have a lot of cracks and fissures as that indicates constipation.
Now, findings by researchers at the American College of Gastroenterology’s (ACG) 77th Annual Scientific meeting in Las Vegas in 2012 indicated that individuals stand a greater chance of developing colon cancer. The risk of developing colon cancer was 1.78 times higher for chronic constipation patients.
Researchers found that both colon cancer and benign neoplasms are more prevalent in chronic constipation patients compared to a control population free from chronic constipation. They had ruled out potential confounding factors, including age, gender, family history of cancers, and other intestinal problems.
They suggested that constipation increases the duration of contact between the walls of the colon and concentrated cancer-causing substances in the lumen, such as bile acids.
Head of Radiation Oncology, University College Hospital UCH), Ibadan, Professor Adeniyi Adenipekun, stated that colon cancer was the fifth commonest cancer seen at the hospital, adding that its incidence in both sexes is on the rise in Nigeria.
He said individuals can also avail themselves of blood tests to ascertain specific tumour markers for colon cancer which could either confirm or rule out a diagnosis of colorectal cancer since its symptoms can go unnoticed during the early stages of the disease.
Professor Adenipekun assured that colon cancer is treatable if detected early. Nine out of 10 patients will survive five or more years when colon cancer is caught in its early stages.
According to him, “curability depends on the type of cancer and also what stage at which it is picked. As long as the cancer is picked early, the chance of curability is very high.
“Unfortunately, in this environment, above 70 per cent of our cancer patients present in late stages when cure is almost impossible. That gives people the impression that cancer is not curable. Sadly, by the time they come in, it is almost too late to do anything.”
Fortunately, colon cancer rates have dropped over the last 10 years due to the rise in colonoscopies and colon cancer screenings. In addition to regular screenings, recognising the common signs and symptoms of colon cancer can save a life.
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