Key Bowel Symptoms

These are the Key Symptoms that you should to look out for … plus when should you see your GP and how you should be investigated if they persist in spite of simple treatments and you are referred to hospital:

  1. The most important symptoms are going more frequently to the loo to pass softer, looser poo with blood– if this persists for more than 4-6 weeks, see your GP who will probably advise investigation at any age but especially over 40 by a short 5-minute examination in outpatients without sedation and after simple bowel cleaning – known as “flexi sig”
  2. Going more frequently to pass softer/looser poo for more than 4-6 weeks without bleeding – you should see your GP and if your symptoms do not settle quickly and you will probably be referred for investigation by ‘flexi sig’ particularly if you are over 50.
  3. Persistent rectal bleeding without a change in bowel habit particularly without any pile symptoms for 4-6 weeks:
    In people over 50 – you should see your GP who will probably examine your back passage and if this is normal but the bleeding persists you will be referred to hospital fairly promptly to be investigated by ‘flexi sig’.
    In people below 50 – you should see your GP who will probably examine your back passage and if this is normal but the bleeding doesn’t quickly respond to simple treatments you will be referred to a routine clinic for ‘flex sig’.
  4. Iron deficiency anaemia found in a blood test done by your doctor – all men and women after the menopause should be investigated by colonoscopy if there is no obvious cause for the iron deficiency anaemia even if they have no bowel symptoms –
    in most women before the menopause anaemia is due to their periods but if there is any doubt and it keeps coming back after stopping treatment with iron they should have tests to exclude serious disease
  5. Patients with iron deficiency anaemia and one of the three primary symptoms of bowel cancer – most can be simply diagnosed by ‘flexi-sig’ – however if this is normal the rest will need colonoscopy or a CT scan
  6. Lump in tummy or bottom felt by doctor – ask your GP to check as you may not be able to feel it! If you have a lump in your tummy you will need a CT scan.
    Important: Most people with bowel symptoms do not have cancer and their symptoms settle quickly with simple self-treatments, perhaps with advice from a pharmacist. The key to avoiding unnecessary investigations and worry is to ‘treat watch and wait’
    which does no harm – only those with persistent symptoms need to see their GP for examination and a blood test.

All patients with bowel symptoms persisting for more than 4-6 weeks in spite of simple self-treatments should see their GP. Most will not have serious conditions but your GP is likely to examine your tummy and bottom and do a blood test to exclude
the common associated signs of bowel cancer. Bowel symptoms are common in other conditions and unless you have at least one of the above key symptoms unremitting and persistent with a normal examination and blood test signs – it is highly unlikely you have any serious condition of your bowel but all people and patients with persistent symptoms will eventually need a simple ‘flex sig’ which takes a few minutes after a suppository at home without sedation in an outpatient clinic without admission to hospital.