The importance of early diagnosis for inflammatory bowel disease and bowel cancer
Written in association with:Toilet talk generally isn’t considered polite conversation. However, keeping silent about your bowel health can prove to be dangerous. Too often, those suffering from gastroenterological conditions such as inflammatory bowel diseases (IBD) or bowel cancer are diagnosed late during more advanced stages, which can have an impact on disease prognosis. Dr Polychronis Pavlidis, consultant gastroenterologist and expert in all things gastrointestinal, stresses the importance of early diagnosis for these conditions.
IBD is an umbrella term for a variety of chronic diseases that affect the gastrointestinal (GI) tract, the most common kinds being Crohn’s disease and ulcerative colitis. Crohn’s disease can impact any part of the GI tract but is mostly found at the end of the small intestine and the beginning of the colon. Ulcerative colitis mostly affects the colon and the rectum. IBD can start at a young age, with many diagnoses made around 15 to 30 years of age, and can be due to genetic predisposition as well as environmental factors like diet and lifestyle habits. It’s not uncommon though for people to also be diagnosed at their 50-60s highlighting the importance of awareness and early access to a specialist regardless of ones age.
Bowel or colorectal cancer starts with little growths in the colon or rectum, called polyps. Usually these polyps aren’t initially harmful but as they grow and spread they may turn into cancerous tumours. Checking for polyps (screening) is key in preventing cancer development or for early diagnosis. In the United States bowel cancer screening for people with average risk for colorectal cancer is advisable to start at 45 while in England the National Bowel Screening programme aims to start screening at 50. A family history of bowel cancer is something to take into consideration when age to start screening is considered with those who have relatives with the diagnosis or other related cancers (for example breast, ovarian) required to start screening at a much younger age.
Symptoms of gastroeneterological diseases
Signs that something in your GI tract might be wrong are:
- changes to your bathroom habits – either diarrhoea or intense urgency to go to the bathroom; or as a polar opposite, constipation
- abdominal pain
- bloating
- unexplained weight loss
- fatigue
- blood in your stool
Conditions affecting the GI tract tend to be diagnosed late because either symptoms start late or they are are not taken as seriously. It is common for these signs not to be too obvious, mistaken as normal or attributed to a different health issue. People may feel embarrassed and choose not to seek assistance.
Having access to a friendly, proactive specialist is key in taking those steps to evaluate symptoms holistically and organise the appropriate tests quickly in order to make the correct diagnosis early or provide the necessary reassurance with confidence.
Screening and diagnosis
While imaging like ultrasound, CT and MRI can aid and be complimentary in investigating GI symptoms, endoscopy (i.e. colonoscopy) remains the gold standard for the diagnosis of IBD and bowel cancer.
Besides the optical views of the bowel lining it allows sampling and tissue assessment under the microscope which can help shape further treatments. Importantly, it provides an opportunity to identify and remove those polyps early before they turn into cancer.
Benefits of early diagnosis
Treating a disease in an advanced stage has implications on prognosis. By the time it is diagnosed, it could be at the point where damage has progressed and the outlook may be poor. This is why early diagnosis is so important: if the symptoms are noted and reported at an early stage and the right tests are performed in a timely fashion the treatment has a higher chance of success, as well as being less invasive or intrusive.
According to Cancer Research UK, 90 per cent of people with bowel cancer survive for five years or more when diagnosed at the earliest stage, but for those with a later diagnosis, this drops to only 10 per cent. At early stages the cancer is localised and can even be dealt with topically but at later stages this may not be possible, or systemic treatment may be required.
Early diagnosis and treatment is key for IBD as well. The recently published pan-UK study PROFILE reported that starting effective treatment early (within two weeks) from diagnosis of Crohn’s disease can reduce the risk of surgery or hospitalisations within twelve months of follow up with fewer side effects of disease and treatments.
If you have concerns regarding your gastrointestinal tract or are exhibiting the above symptoms, Dr Polychronis Pavlidis is available for consultation via his Top Doctors profile.
