Colorectal

Cancer types

The bowel is part of the digestive system stretching from the stomach to the anus.

It is a hollow tube coiled up in your abdomen, divided into two parts: the small bowel and the large bowel (the colon and the rectum). Cancer in the large bowel is known as colorectal cancer.

What symptoms might need an urgent referral?

  • A new and definite change in your bowel pattern – increased frequency or change in consistency
  • Rectal bleeding – persistent or intermittent, fresh or darker blood
  • Abdominal pain and increased bloating
  • Loss of appetite, or unintentional weight loss, with persistent tiredness

Colorectal Diagnostic Tests

Faecal Immunochemical Test (FIT)

Faecal Immunochemical Test (FIT) is a stool test designed to identify possible signs of bowel disease. It detects minute amounts of blood in faeces (faecal occult blood). Many bowel abnormalities which may develop into cancer over time, are more likely to bleed than normal tissue. So, if there is blood in the stool this can indicate the presence of abnormalities in the bowel. Patients with a positive FIT result are referred for further investigation by colonoscopy. The FIT test result may also help you to avoid unnecessary investigations.

The test has a stick attached to the lid. This is used to take one small poo sample and then placed back into the tube. Full instructions and a detailed information leaflet will be sent/given to you with your test.

The test kit should have been given to you by your GP Surgery. If not, please request one urgently.

Based on the result of the FIT test you are likely to be put forward to either:

  • Direct to test investigations (colonoscopy, CT, CT Colonography)
  • Outpatient appointment – by telephone or face to face

Colonoscopy/sigmoidoscopy

A colonoscopy is a way of examining the lining of the bowel from the inside. A doctor or nurse passes a thin flexible tube (colonoscope) into your back passage. The tube has a tiny light and camera on the end to show any abnormal areas.

A colonoscopy can also see whether there are any small growths (polyps) in the lining of the bowel. It is one of the main tests used to diagnose bowel cancer. The procedure is performed in the hospital endoscopy department and takes about 30 minutes.

During the colonoscopy, photographs and samples (biopsies) of the cells on the inside of the large bowel can be taken. Most polyps can be painlessly removed using a wire loop that is passed down the colonoscope.

The bowel has to be completely empty for a colonoscopy. This means following a careful diet for a few days before your test. You will also need to take laxatives, which the hospital will provide. The department carrying out your colonoscopy will give you instructions about your diet, and about exactly when to take your laxatives. Some of the regular medicines you take may have to be stopped prior to the colonoscopy. This too will be explained to you.

For further information about the Endoscopy Department, including patient information leaflets, is available – Endoscopy

Virtual Colonoscopy

In a virtual colonoscopy (CT colonography), a CT scanner┬átakes a series of x-rays, which builds up a 3D picture of your bowel. It is done in the hospital CT department and you can usually have it as an outpatient. This test may be done instead of a colonoscopy, or if the colonoscopy didn’t give a clear enough picture.