Bowel polyps and bowel cancer - Dr Subramaniam Ramakrishnan, Consultant Gastroenterologist

Bowel cancer (also known as colorectal, rectal or colon cancer) is a type of cancer that commonly develops in the large bowel. The first stage of bowel cancer is thought to arise from a polyp, a fleshy new growth in the bowel or rectum. This is usually benign but if left alone can develop into cancer. For this reason, if polyps are discovered in your bowel then you will need to have them examined and removed to prevent progression to bowel cancer.

How can bowel polyps be detected and what do they mean?

Most people are unaware that they have polyps. If there are family members who have had polyps or bowel cancer than it is recommended that you undergo tests for polyps. Smaller polyps don’t cause any symptoms so you’re unlikely to discover you have them unless you have a bowel or rectal investigation for another reason. 

However, if polyps grow to a large enough size then you may notice the following symptoms: 

  • Bleeding from the back passage – you may notice this in your stools or on the toilet paper when you wipe your bottom
  • A change in your bowel habits, such as diarrhea or constipation

A procedure called colonoscopy is the best way to diagnose and treat polyps. If polyps are discovered then they can be removed at the same time using special instruments. 

Are all bowel polyps cancerous?
After the polyp has been removed, it will be sent to a laboratory to check if it is cancerous. If cancer cells are found in the polyp, then it’s likely you’ll need further investigations and treatment for cancer. If the polyps are reported to be benign then further examination will be planned depending on the size, number and nature of the polyps.

What are the risks of developing bowel polyps and bowel cancer?

 There are certain risk factors which could increase your chance of developing bowel cancer –

  • Age - the older the age the higher the risk. However younger people can also develop bowel cancer depending on the number of risk factors - every year over 2,000 younger people are diagnosed with bowel cancer, some as young as teenagers
  • Diet high in red meat and low in fibre
  • Obesity
  • Drinking too much alcohol
  • Smoking
  • Family history of bowel cancer


What are the other signs of bowel cancer? 

Many of the symptoms of polyps are similar to those of bowel cancer, the difference is that the symptoms (blood in the stools, abdominal pain and diarrhea or constipation) will be persistent. For example, blood in your stools could be piles or anal fissures (a small tear in the anus), but if these are treated and the problem persists then it could indicate something more serious.

Other symptoms to look out for include: 

  • Not feeling as though your bowel is fully emptied after going to the toilet
  • Unexplained weight loss
  • Pain in the back passage
  • Anemia (which is diagnosed via a blood test) 

Sometimes cancerous growths can block the bowel, causing bloating, constipation and vomiting.

How can bowel cancer be detected early? 

Cancer screening for people between 60 and 74 is available on the NHS but if you are younger than this, or are particularly worried about your symptoms then you can speak to your GP or a private GP or consultant about your symptoms and diagnostic options.

There are numerous ways you can be tested for bowel cancer and although it might be embarrassing to speak to someone about your symptoms, it’s in your initial consultation where your GP will be able to assess your risk based on your symptoms, age and medical history. They will also examine your back passage to see if they can feel any lumps, this will be painless but will feel uncomfortable and you may have a similar sensation to when you pass a stool.

After an initial consultation, you may be referred to see a consultant or referred for further tests. If you prefer, you can speak to Spire Cheshire Hospital on 01925 215 029.

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