Altered Bowel Habit – An Overrated Symptom for Colorectal Cancer

Aims: To determine if altered bowel habit alone is one of the main clinical presentations of patient with colorectal cancer (CRC) in a single district hospital.

Methods: A Proforma was designed after literature review .Any patient presented to Sligo General Hospital with CRC was included in this retrospective study. The cases identified from hospital inpatient enquiry (HIPE) data from 01/2001 to 01/2003

Results: 100 cases of diagnosed CRC were analyzed. The clinical presentations included anaemia, rectal bleeding, abdominal pain, abdominal mass, intestinal obstruction, intestinal perforation, altered bowel habit and cachexia. 45% were male [mean aged 72.5] and 55% were female [mean aged 72.7], the main age group 60–86 years.

18% had a single feature: Anaemia (8%), rectal bleeding (7%), abdominal pain (2%), whereas altered bowel habit alone was 1%. Of the remainder (82%): 32% had 2 features, 25% had 3, 17% had 4, 6% had 5 and 2% had 6 features.

Conclusions: Altered bowel habit alone is a very uncommon clinical presentation in CRC. Instead, we recommend that patients with iron deficiency anaemia or rectal bleeding alone should be prioritized when investigating for CRC along with patients who have 2 or more of the typical presenting features.