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7/30/2019 Melatrol has an amount of melatonin to supplement your biological creation

1/20

LOOK BEHINDYOUR SYMPTOMS

by Lynn Faulds Wood

BOWEL CANCERand other bowel problems

HOW TO TEST IF YOURSYMPTOMS MIGHT

BE SERIOUS

Includes hints and tips oncontrolling constipation,

diarrhoea and rectal bleeding.


2/20

Twenty years ago, I wasco-presenter of the BBCsWatchdog programme withmy husband John Stapleton.We had a three year oldson. Life could not have beenbetter. Then, out of theblue, after nearly a year ofmedical delay, I was diagnosed

with advanced bowel cancer.I had never even heard of

the disease, did not know that it is the second commonestcancer which kills people in this country, after lung cancer.

I was lucky to survive and pledged to spend most of mytime investigating how to help save the thousands ofpeople who die unnecessarily of bowel cancer every year.

So far, I have helped to come up with a new, research-based guide to symptoms, now officially adopted by theDepartment of Health, helped to set up better diagnostictraining schemes and centres for doctors and nurses, helpedto create patient feedback events so we can have our say inimproving cancer services.

Bowel cancer is curable and preventable - if only we canfind it early enough. Most people need early reassurancethat they do not have cancer. We should not spread fearand worry.

People with symptoms dont have to dash off to theirdoctor - there is time to test symptoms safely to see if theywill go away. Thats what this leaflet is all about.

I hope you find it helpful.

Contents:

Suffering from any of these?

Look behind your symptoms

Have you got any of these?

How to test your symptoms

Other peoples stories

What does the bowel do?

Constipated?

Common SymptomsWhat to do about them

What to do if its in

your familyWhat other conditions couldcause your symptoms?

What to do about them

If your GP recommendshospital investigation

What type of test?

Words-Words-Words

Helpful Contacts

p2

p3

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p5

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p7

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p9, 10 & 11

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This leaflet is endorsed by theAssociation of Coloproctology

(Bowel Specialists) of Great Britainand Ireland.

Huge thanks to the people ofPortsmouth and consultant

Mike Thompson (formerpresident of the ACPGBI) and the

Portsmouth Surgical Research Group(research scientist Karen Flashman,

GP Brian Ellis and

consultant surgeonsAsha Senapati, Daniel OLeary)for all their help in preparing

this leaflet.

All text Lynn Faulds Wood 2011

Lynns Bowel Cancer Campaign


3/20

Most people withseemingly worrying

symptoms do not havecancer, do NOT have

something seriouslywrong with them.

FACT:

Feelings of discomfort,bloating, sickness, pain, wind,grumbling guts, bleeding from

the bottom, diarrhoea,constipation, mucus withstools, losing weight, fatigue,off your food?

If youve never had problems with yourinsides, youre lucky.

Most of us have them.

But how can you tell if theyre serious ornot?

Can you safely test your symptoms?

When should you go to the doctor?

This leaflet is designed to look behindyour symptoms, to help you decidewith confidence what to do next.

One in five of us has bleeding from thebottom at some time every year - yetover 99% of people with bleeding do nothave cancer. Even more millions suffer

short-lasting bowel upsets andabdominal pain.

For most of us, these are common,non-serious symptoms and we dont needto do much about them.

But how can you tell?

2

Suffering from anyof these?

GrumblingGuts?

Oh.. I feel terrible

Why doesnt he dosomething about me?


4/20

A torch may helpyou see

3

Look behindyour symptoms

People experience all sorts of vaguesymptoms, like general discomfort downbelow. But these usually come and gowithin 3-4 weeks. If the symptoms arenot severe, do not stop you from doing

your work, eating or sleeping, it is safeto watch-and-wait for a few weeks.But consider this. Behind the vaguefeelings, you might be missingunderlying symptoms which could beeven more important.

Try asking yourself these questions:

Has there been a change in mybowel habits recently? Say going tothe loo - or trying to go more often withnothing happening (some people call thisconstipation) Do these changes continueday after day with no complete returnto normal?

Has the consistency of my poochanged? Is it looser, softer, morediarrhoea-like without returning tonormal?

Is there bleeding? In the pan or onthe toilet paper and it keeps happeningfor no reason? A torch may help you

see.

Could I be anaemic?Severe anaemiacan produce symptoms of tiredness,

breathlessness and lack of energy.These symptoms are common and notusually caused by anaemia.

Have I persisting pain in my tummywhich comes on almost alwaysafter eating, putting me off my

food and Im losing weight?Painin the tummy without this pattern ofsymptoms is almost always not serious.

If I have symptoms, is there a

history of bowel cancer in myfamily?Most people with a familyhistory are not at a seriously increasedlifetime risk (see page 12) but if youhave persisting symptoms and a geneticrisk, see your doctor.

If I have ulcerative colitis?Extensivecolitis for more than 10 years - youshould be under special review at ahospital. Shorter length of time - noextra risk.


5/20

Some GPs won't offer a

rectal exam with a

gloved finger -

we need to encouragemore to do it.

FACT:

The commonest symptoms ofbowel cancer are:CHANGE OF BOWEL HABIT,

RECTAL BLEEDINGand ABDOMINAL PAIN,but these are very common inpeople who do not havecancer.

These are the HIGHER RISKsymptoms to look out for, behind

any other symptoms you mighthave:

Change of bowel habitWITH bleedinga recent persistent change whichlastsfor a few weeks without returningto normal. To looser, more diarrhoea-like motions

To going to the loo several more timesa day than normal or trying to go

People with these symptoms should bereferred to hospital for investigation ATANY AGE.

Change of bowel habit WITHOUTbleeding

Looser, more frequent - people shouldbe referred to hospital if in an olderage group.

Rectal Bleeding - bleeding from thebottom Over 55 - everyone should be

investigated just in case.

Rectal Bleeding under 55If there is no good reason for thebleeding (no straining, piles, pain etc)and it keeps coming and going, youshould probably be referred forinvestigation.

Other higher risk symptoms include:

Unexplained iron deficient anaemiafound by your GP

A lump or mass in your tummy felt byyour GP

Persistently colicky severe abdominalpain, which has come on recently forthe first time, if you are in an olderage group.

4

Have you gotany of these?


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A stool samplemay be useful

Bowel cancer - also known ascolorectal and colon cancer -

is common.After lung cancer, it is the

second commonest cancerkiller in this country. It usuallyaffects older people, over 60.

FACT:

If you can make your symptoms goaway or improve a lot, then it is highlyunlikely you have bowel cancer.

Heres how to test them:

Diet - try different things, like fibre:eating more (if youre constipated) orless (for more diarrhoea-like symptoms).

Fibre includes wholemeal bread andcereals, fruit and vegetables.

Try drinking more fluids.

Change your lifestyle -if youre acouch potato, try taking more exercise,like brisk walking for half an hour aday. Exercise gets the guts moving.

Give up smoking and heavy beerconsumption.

Talk to your pharmacist - aboutremedies you can buy or changing yourdiet. Symptoms may go away while youare taking these remedies - if they comeback once you stop, or if symptomspersist for up to four weeks, see yourGP.

Get advice from your GP - theaverage patient gets eight minutes withtheir GP so get straight to the point.GPs are used to talking about intimate

subjects and will not be embarrassed totalk about your symptoms.

Bleeding from the bottom?Ask your GP if you should have a PR,stands for per rectum - a gentle, quickexamination with a gloved finger to feelfor any suspicious lumps which might becancer.

5

How to testyour symptoms


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6

Our stories

Lynns story: I looked down the loo one day and thoughtI spotted traces of blood. The next time I went, I shone a

torch down and definitely saw traces - quite subtle butdefinitely a bit of bleeding. I mentioned it to the GP nextvisit and he said "nothing to worry about at your age,probably piles," but at least he gave me a digitalexamination.

The bleeding - still subtle - came and went with no reasonfor it, so five months later (I'll never know why as I had nosuspicions it might be serious) I went to see the wisest GP

at the practice and asked to be referred to a specialist. Because no one was worried, Iwasn't fast tracked. Finally, nearly a year after I went to the first GP, I was diagnosedwith advanced bowel cancer in the lymph nodes. My son was just three - it was aterrible shock. I had no chemo - it was twenty years ago - today I am still here andcured.

* Anybody with persistant bleeding without any obvious reason may needhospital investigation at any age.

Norman's story:Norman Gordon was colourblind - 1 in 12 men are colourblind -usually having problems with the red end of the colour spectrum. That can make itdifficult to spot bleeding from the bottom. Norman didn't know that he had rectalbleeding until it was too late and he died at 53 of bowel cancer. His wife Brigette says:Norman was very colourblind. He used to wear odd combinations of colours. One dayhe asked me to look in the toilet to see if there was anything wrong and I was shocked

to see blood, a lot of it. He couldn't seeit and he had had the symptom for some

time."

Colourblindness tends to run infamilies. So does bowel cancer.Norman's father was diagnosed twoyears before Norman, his uncle 18months after Norman died. If your

family is affected by colourblindness(it almost always affects men) and

bowel cancer, ask your GP aboutscreening and genetic advice in yourarea.

Norman and Brigette Gordon

John, Lynn and Nick


8/20

Gut, bowel, large bowel, intestine,colon and rectum. We use many words

to describe our guts but basically thisleaflet is referring to the long tube ofmuscle running from the appendixthrough the colon and down to therectum.

When we eat, food passes down intoour stomach then nutrients are absorbedthrough the bowel lining and into our

bodies. The leftovers progress into thelarge bowel - a sort of fermentingstorage area - which can produce gas.In some people, this may be the cause oftheir bloating, discomfort, evenabdominal pain, if the bowel isntdealing with this smoothly. Reasons forthis can include not enough - or toomuch - roughage or fibre in our diet.

The remaining food matter (motions)is mostly stored on the right side of thebowel then once or twice a day in amass movement, moves to the left whenwe get an urge to go to the loo. Themotions can be held in the rectum orback passage until we can get to a loo.

The bowel secretes mucus to helpmove the waste along, which is whypeople may spot mucus in their stools.Water is removed along the way and,if you dont go to the loo every day ormost days, more water can be absorbed,making your motions firmer and moredifficult to pass. Thats why going to the

loo when you feel the need is a goodidea and why its important for the

young to develop good bowel habits.

7

What does the bowel do?

Liver

Lungs

Anal Canal

AscendingColon

Anusexpels motions

Appendix


9/20

8

Constipated?Try: A higher fibre diet with more fruit and

vegetables, more wholemeal bread andcereals - prunes and figs may help tosoften the stool.

Not drinking enough? Increase fluidintake (water, tea, juice and coffee).

Dont delay going to the loo when youhave the urge.

Exercise can stimulate the muscles inthe gut to work more effectively -joggers often find they go morefrequently.Brisk walking works wonders!

Remedies recommended by yourpharmacist, like Lactulose (which

makes the motions softer), Fybogel(which adds bulk to the motion),Sennakot (which stimulates the bowelto work).

Dont use laxatives for months withoutconsulting your doctor. If they work,stop taking them after a few weeks orcouple of months and, if your bowelaction doesnt stay normal,see your GP.

Its ok to strain a bit to stimulate thebowel to work but too much strainingisnt helpful - waiting till you geta stronger urge to go should dono harm.

Chatting through your symptoms with apharmacist to test them before you seeyour GP is a good-idea.

Descending Colon

Transverse Colon

Small Intestineabsorbs nutrientsfrom our food

Sigmoid Colonfor storing

motions

Rectumholds back themotions untilready to go

Storesmotions

Direction of food/motions

Absorbs water

Foodferments

here


10/20

9

Common Symptoms in detailand what to do with them

FACTThe chances of developing bowel cancerincrease as you get older - 90% ofof people affected are over 50.

BLEEDING FROM THE BOTTOMFive million of us have bleeding from thebottom every year, especially in our 20sand 30s - its pretty normal. Most of the

time, were good at deciding if it mightbe serious - and so are our GPs.So when should you take bleedingmore seriously?

Over 50 - dont assume piles. Mostpeople will not have cancer but persistentbleeding for weeks/months should bechecked with your GP.

At any age No obvious reason for your

bleeding, no itching, no irritation, nopain and the bleeding persists formore than two or three months -see your GP.

Sudden large amounts of bleeding after going to the toilet looksfrightening and worries us - yet,paradoxically, it usually means wedont have cancer. If it stopsimmediately, this is usually caused byconditions like piles, rarely by cancer.

In patients who have cancers which

bleed a lot, the bleeding will not stop.It is also not usually fresh blood(the colour of a cut finger) but changedin colour.

People with both bleeding andpersistent changes in their bowels tomore frequent and/or looser should bereferred for investigation at any age.

If you are worried about bleedingand cant get it off your mind, seeyour GP. Its a perfectly good reason

for going. You may need hospital

investigation, to reassure you, eventhough you have little risk of bowelcancer.

PILES - OR CUSHIONS?The good news - bleeding from thebottom is common and natural for mostof us - especially younger people - andmost diagnoses of piles probably arent

piles at all!If we do go to the doctor/specialist withbleeding from the bottom, were oftentold its probably your piles. Doctorsthink this reassures us but many peopledont like the thought of having piles,believing they must have done somethingwrong (bad diet, bad habits, strainingetc) to get them. Bleeding affects one infive of us in any year and can continueon and off throughout our lives.The bleeding, usually short bursts for afew days at a time, comes fromcushions around the anus - naturalspongy bulges of tissue and bloodvessels which close the anal canal tohold in gases. Pass a hard motion or

strain and they can bleed easily,especially when were younger.


11/20

Are you sureits piles, Doc?

It means different things todifferent folks: not going

frequently, passing hard stools,bloating. Passing hard stools is

less likely to be serious -its persistently looser stools

which need watching.

CONSTIPATION FACTS:

Bleeding for no reason isuncommon.It mostly goes away with no treatment.Perhaps the word piles should be keptfor patients whose cushions are so largethey come through the anal canal and

the patient has to push them back(prolapsed piles). These may needsurgical treatment.If you are straining and grape like littlelumps appear around the anus,disappearing when you stop straining,theyre normal too.Occasionally a painful clot can form in

one of them - thats known as athrombosed pile.

What can be done to controlbleeding? Change your diet to more fibre/more

fluids so that the motions are softerand easier to pass

Straining a lot is an important cause

of bleeding or piles - some straining tostart the bowels working is normal buttry to avoid excessive straining.

Try buying products at the chemistsbut, as bleeding tends to come and go,it can be hard to know if the producthas worked.

If bleeding is a nuisance and you are

referred to hospital, injections orrubber banding can control it in theshort term.

Many patients get bleeding on and offin early adult life, whatever is done tothem. All hospital treatments involvesome discomfort but this usually settlesdown quickly.

Larger piles - banding with a rubberband to shrivel them. Quick but doesnot always work.Really large piles -usually surgery theonly option but last resort. Recovery canbe painful for a couple of weeks,especially when going to the toilet.Laser, infra-red and cryotherapy treat-

ments have been tried in the past butare not usual treatments at the moment.

10


12/20

Try abetter diet

Scientists have categorised

shape of "poo" in the

Bristol Stool Chart - go to

Google to find out more.

FACT:

CHANGE OFBOWEL HABIT

So common that most of us have these,usually with an obvious cause like

overeating, drinking, foreign travel.Whats not generally known - changescan happen spontaneously, without areason. Very few people have regularbowel habits all their lives. Not serious changes - they usually go

away in 4 weeks. Longer changes should probably be

investigated in hospital though most

will not be cancer.

If you are taking laxatives, they canmake you more frequent and looser.Only way to tell if you have a problem- come off the laxatives and see if yourbowel habit goes back to normal. If youhave noticed a recent change in your

bowels, which wont go away, especiallyif there is bleeding, go to your doctor.

Shape of pooPeople get worried by the shape,especially if motions are long and thin,

imagining this must be due to anarrowing of the bowel higher up,perhaps due to cancer.Dont be alarmed.Shape is determined by the anal canal,the last bit of the bowel. If this doesntrelax completely when you go to the loofor some reason, motions get long andthin.

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Common Symptoms in detailand what to do with themcontd


13/20

Floaters and sinkersPeople with a high fibre diet

(lots of fruit and veg,wholemeal bread and

cereals etc) are more likelyto have stools or poo whichfloats. Not only is this better

for your body, it also makes iteasier to spot if you have aproblem with your insides.

FACT:

TV presenter Matthew Wright

has the bowel cancer geneLynch Syndrome (HNPCC) in hisfamily. Lynn pushed him to be

tested and luckily Matthew is thefirst male not to have the gene.

12

What to do ifits in your

family?Bowel cancer affects one in ten

families.But that doesnt mean youre going toget it, if it is in your family.

Rough rule of thumb: the closer therelatives are to you (brother, sister,mother, father, child) and the youngerthey were when diagnosed, the moreyou need to do something about it.

One close relative under 45 affected(brother, sister, parent or child) talk toyour GP about screening possibilities in

your area.

Two or more older close relatives fromthe same side of the family.The younger your relatives, the moreneed for you to discuss screening withyour GP.

Usual yardstick for screening - around10 years before the age at which youryoungest close relative developed thedisease.

If you have a less strong family history,

say one grandparent who died in their60s or 70s, you have very little lifetime increased risk and screening is no

more appropriate for you than patientswith no family history at all.

Talk to your GP if you are worried.

Talk about bowel cancer. You could helpsave your life or the life of someone inyour family just by chatting about it andsharing this leaflet with them.


14/20

Women between 20-40 aremost likely to have bleeding

from the bottom,usually after having a baby.Young men also commonlybleed, but this decreases as

we all get older.

FACT:

13

What other conditions couldcause your symptoms?

Fissures - split or tear in the lining oflast tiny bit of the anal canal, sometimescaused by constipation - may causebleeding which drips into the toilet bowl.Nearly always associated with severe

pain when going to the toilet. Can beitchy, especially in women.

Irritable bowel syndrome (IBS) - thisdiagnosis should only safely be madeafter referral to hospital for examination.Very common - over one third of us willhave irritable bowel symptoms each yearand not be referred. Symptoms similar

to bowel cancer but dont persist, theycome and go, with long stretches wherethe gut goes back to normal. Many IBSpatients have recurring symptoms whichneed investigation at some time to makesure it is not more serious.

Polyps - warty like growths on thebowel lining. Most dont have symptoms,dont cause cancer and are not usuallydiscovered unless you are having othertests. Larger polyps can causebleeding and around 3 per cent arethought more likely to turn cancerous.Removing these can usually be done byan internal flexible probe (endoscope)without the need for an operation. By

screening people over 50 for importantpolyps, it is thought most bowel cancerscould be prevented in the future.

Crohns disease - painful inflammationof the gut. No one knows the cause -may be life long. More common insmokers. Long time sufferers may have aslightly increased risk of bowel cancer

Ulcerative Colitis - where the bowelbecomes red and inflamed. May be lifelong. Tends to come and go withsymptoms like bleeding and mucus, lessoften pain (often after a poo) Long timesufferers, over 10 years, at increasedrisk.

Diverticular disease - becomesincreasingly common as we get older.Half of us over 60 have some it. Mostpeople have no symptoms, occasionallycauses changes in bowel habits,abdominal pain and more rarely, severeinflammation, which occasionally needsmajor surgery to correct. It doesntpredispose you to cancer.


15/20

14

What to do about them

Abscess - doctors need to be consultedand will either try a course of antibiot-

ics or refer you to hospital for surgicaltreatment to cut the abscess and let outthe pus.

Piles - as most symptoms go away,most people dont treat them. However,if symptoms persist, ask a goodpharmacist/chemist for self-treatmentslike cream or suppositories.

Some bleeding from piles is a nuisanceand needs hospital treatment (injections,banding) or advice about changing yourdiet.

IBS - Fortunately for most people thesymptoms tend to be mild, pass andneed little or no treatment. If diarrhoeais the symptom - try a low fibre diet

with or without constipating drugs likeLomotil and Imodium.Constipation - high fibre diet.Abdominal pain and bloating - majorsymptoms which are extremely difficultto treat - most settle by themselves orcome and go so you get periods of relief.If symptoms persist, go to your doctor to

exclude anything more serious. For some,IBS is a severe problem in their work andhome lives, very difficult to cope with.

Polyps - can be removed by colonoscopywith a tiny electric snare and tested(biopsied) to make sure they are benign(safe). Some bleed but most will neverturn to cancer.

Crohns disease and Colitis - contactthe National Association For Colitis and

Crohns Disease for booklets - details atthe back.

Fissures - mostly treated by specialcreams which relax the muscles, orinjections with Botox. Most people dontneed surgery but, if they do, its a verysimple operation. Unfortunately it canleave some people, especially women,

with leakage problems (mucus, evensmall amounts of stool.) In over 90 percent of patients, the operation isexcellent, has few complications and is apermanent cure.

Diverticular disease - major symptomscan be controlled by changes in the diet.Going to the loo more frequently? Unlike

other bowel conditions, try reducingthe amount of fibre you eat - try whitebread and rice, avoid cereals with wheatfibres, reduce fruit, take normal amountsof veg. Loose stools - do the same but ifchanging the diet doesnt work, try anti-diarrhoea medication from the chemist.Only rarely should surgery be needed.

Constipation - change to a high fibrediet, more fluids.


16/20

Smoking, heavy beer

drinking and eating lots of

red meat increase the risk

of bowel cancer.

FACT:

some questions you might like toask:

How quickly will I be seen?Is it an urgent or a routine referral?

Urgent doesnt mean you have cancer!People with higher risk symptoms shouldbe seen within two weeks of referral forinvestigation.Most people with these symptoms do nothave cancer but it should be ruled out.

How long is the waiting list forroutine referral?

This varies around the country but itcould mean several months. If lists arelong and you are worried, say so.

What kind of investigation are yourecommending?Resources vary around the country and,depending on your symptoms, some testsmay be better than others.

Am I seeing a specialist?Ask if your GP knows the doctor towhom you are being sent, is he/sheexperienced in dealing with bowel cancerand what does your GP think of them.Many people are now sent to diagnosticclinics run by specialist nurses or doctors.

Is the specialist part of a team?If you do have cancer, research showsthat patients treated by the teamapproach do better. That is, treated bya doctor or surgeon who is part of amulti-disciplinary team, where all theprofessionals involved in your care worktogether and hold meetings todiscuss your care.

15

If your GPrecommends

hospitalinvestigation

What investigationmight your GPrecommend


17/20

First another bit of reassurance:most people referred for investigationdont turn out to have cancer.How you are investigated depends onwhats available at your hospital.

Rigid sigmoidoscope (20 cm)Most patients probably get a quick lookinside with one of these, like a thin short

telescope. It takes a few minutes.

Flexible sigmoidoscopeA thin flexible tube, with a camera orlight on the end. It can look inside the

first60-70 cms ofthe bowel.

You maybe given atreatmentto clear theend of yourinsides touse at homethat day orinvited to

hospital a little earlier. Flexi sig is safe,takes only a fewminutes and gets further round the bowelthan a rigid one, good forinvestigating most symptoms.

ColonoscopeA longer version of the sigmoidoscope, along flexible tube which can look insidethe whole colon. You take laxatives

beforehand and stop eating sometimethe day before, to clear out your insides.

Advice varies between hospitals but youcan usually drink liquids like tea/coffeeand a form of sedative is given for theprocedure.

Barium enemaAn X-ray examination with laxativestaken the day before to clear out thebowel. On the day, the colon is filled

with a thick white liquid (bariumsulphate) and X-rays taken from severalangles.Problems with the bowel show up blackagainst the white liquid.

Virtual ColonoscopyVirtual colonoscopy is a bit like acomputer game, using scanners and com-puters to look inside the bowel for polypsand signs of cancer. The scanner usesX-rays to produce two-dimensional andthree-dimensional images of the colonand rectum. Lynn has made a DVD withSt Mark's Hospital of her own virtualcolonoscopy.See our videos on flexi sig andcolonoscopy on www.bowelcancer.tvSt Mark's hospital has made atraining DVD with Lynn.

16

What type of test?

i

t

t

i

Flexible sigmoidoscopecan reach 60-70cm

into the body inmost patients

Lynn and the St Mark's team


18/20

Medical professionals can baffle youwith language. Heres what the words

they commonly use mean:

Anal canal - last bit of back passageAnus - the very end of the rectum, on thesurface of the bottom.Clinician - a hospital (or bed) doctor, itcomes from the Greek word.Colectomy - surgery to remove part or allof the colon.Colic - really severe abdominal or tummypain which comes and goes.Colorectal - of the colon and rectum, as incolorectal cancer.Defaecation - poo.Faeces - poo.Flatus - wind (or a fart).Haemorrhoids - piles, from the Greek forbleeding.

Hemicolectomy - removal of half of thecolon.

Incontinence - inability to hold in stools orurine (wee).Laxative - medicine to soften constipatedstools.Motions - poo.Oncologist - cancer doctor, from theGreek word for a mass or lump, usuallyrefers in the UK to chemotherapy/radiotherapy specialists.Proctitis - inflammation of the rectum.Rectum - storage area above backpassage, contains sphincter muscle to holdback poo till we are ready.Sigmoid - last bit of the colon, above therectum.Sphincter - ring of muscle in anal canal.from the Greek to bind tight.Stools - poo.Waste - poo.

17

Words, Words, Words.

..motions...

posh wordsfor..er

..defaecation..

..faeces..

..stools..

..POO-POO!...

..No 2..

..cr*p..

..s*$?..

Whatever you call itweve got to talk

about it.


19/20

18

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Racing pigeons won 32 medals saving lives in the last war.Now they are saving lives from bowel cancer.

TextLynnFau

ldsWood2008/9/2011

Design:[email protected]

The Hotel Booking Agents Association:Helping to save lives from the second biggest cancer killer.

Bowel Cancer Informationadvice, videos, help from leading experts on prevention,

symptoms, diagnosis, screening, surgery, genetic risk in the UK

www.bowelcancer.tv

See our website for:www.haveigotbowelcancer.com

home symptoms checker with print outto take to your GP

Lynn's Helpful Videos:Screening, Having a Colonoscopy, Flexible Sigmoidoscopy

Keyhole Surgery, Liver Secondaries Surgery, Aspirin - the Wonder DrugPatient Stories ... And lots more.


20/20

RED- Highest risk symptoms: Rectal bleeding with change of bowel

habit to looser stools/going morefrequently.

Lump in tummy or rectum felt by

doctor. Unexplained iron deficient anaemia.

AMBER- Higher risk symptomswhich might need investigating: Recent persistent change of

bowel habit with no bleeding. Bleeding without any reason.

GREEN- A wide range of bowelsymptoms which come and gowithout getting worse: Bloating. Bleeding with a reason

like straining. Change of habit to going less

frequently. Harder stools or changed shape. Mild tummy pain which doesnt

affect your life.

STOP wondering what to do. If yoursymptoms persist for a few weeks seeyour GP - you're likely to be referred tohospital for investigation at anyage but 5 out of 6 people will NOT have

cancer.

WATCH & WAIT - take up to fourweeks to test your symptoms.- try changing your diet andlifestyle, buy remediesfrom the chemist.

- if symptoms persist for four

weeks whatever youtry go to your GP.

GO on with your life reassured youdo not have serious cancersymptoms but if they worry you orlast for more than a few months,see your GP.

Do you know the main symptoms?Try the traffic light test to find out what to do:

Bowel Cancer symptoms?

Bowel Cancer Informationadvice, videos, help from leading experts on prevention,

symptoms, diagnosis, screening, surgery, genetic risk in the UK

www.bowelcancer.tv

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