Pencil thin stool
The new onset of chronic or recurrent constipation or hard stools in patients with risk factors for colon cancer must be investigated.ĭiarrhea, constipation, and hard stool are common with early colon cancers but not specific. Hard stools.Įarly stages of colon cancer (such as stage 0 or stage 1) can present with constipation or hard stools. Symptoms of anemia (due to chronic blood loss) include easy fatigue, headache, dizziness, fast heartbeats, shortness of breath on exertion, etc.Progressive weight loss without trying.A sense of rectal mass or incomplete stool evacuation.Other symptoms & signs of colorectal cancer: Eating excess processed or red meat for many years.Īs gastroenterologists, we consider chronic or recurrent diarrhea after fifty to be a red flag sign.Having diabetes mellitus (the longer the duration of diabetes, the more the risk of colon cancer).Family history of colorectal cancer (especially in the young).Older ages (90% of the cases of colon cancer occur above the age of 50).So, diarrhea or loose stool is not looked at separately your doctor will suspect colorectal cancer if the loose stool is associated with other symptoms and risk factors for colorectal cancer. Associated with other signs or symptoms of colon cancer.The bowel habits changes are persistent or recurrent over relatively long periods (weeks or months).We suspect diarrhea as a symptom/sign of colon cancer when: So, when does diarrhea or loose stool mean colon cancer? More than 99% of the cases of diarrhea are Not every loose (mushy) stool or diarrhea is a sign of early colorectal cancer (CRC). However, These changes in the stool are widespread and far from being a specific sign of colon cancer. Loose stool or diarrhea are common early signs of stage one colon cancer. When does loose stool or diarrhea mean early (stage 1) colon cancer? However, the loose stool or diarrhea can be mixed with red or dark blood. The color of loose stool is often light brown or yellowish. Severe watery diarrhea is found in about 17% of patients with colon cancer ( reference). Recurrent or constant watery stool may be the first sign of stage one colon cancer.Īt diagnosis, 75% of colorectal cancer patients present with bowel habit changes (either diarrhea or constipation). Also, many cases of early-stage colon cancer don’t notice any stool changes.Chronic or recurrent hard stools or constipation.
Since diarrheal states are much more common than CRC, in the absence of authentic symptomatology of CRC, such as rectal bleeding, change in the bowel habit, tenesmus, left-sided abdominal cramps, anemia, etc., the referral of these patients for colonoscopy based solely on "decreased stool caliber" is unwarranted. Our own everyday experience shows that low caliber stool is noticed whenever we have loose stool.
Nevertheless, this misconception somehow permeated the standard textbooks of medicine and even the newer editions of text-books of gastroenterology. In the absence of reliable data to support this concept, the authors of gastroenterology textbooks in the mid-twentieth century practically dismissed the concept.
presence of tumor results in narrowing of the colon, which in turn decreases the caliber of the stool-was conceived late in the nineteenth century. A review of the literature reveals that this rather lay misconception-i.e. Over the past several years, primary care providers have been referring a large number of their patients to gastroenterologists for colonoscopy because of "low caliber stool" or "pencil thin stool." Most textbooks of internal medicine and gastroenterology consider "small caliber stool" as one of the presenting signs of colorectal cancer (CRC).