ABOUT BOWEL CANCER
Inflammatory Bowel Disease (IBD)
Inflammatory Bowel Disease (IBD) is a medical term for a range of conditions where the intestine becomes inflamed and swollen. Around 20,000 people in New Zealand are thought to be affected by IBD.
The two main types of IBD are Crohn’s disease and ulcerative colitis. These are autoimmune diseases, where the body attacks the digestive system.
Note that Inflammatory Bowel Disease (IBD) is not the same as Irritable Bowel Syndrome (IBS) – which is a very different condition.
What’s the connection between IBD and bowel cancer?
The signs and symptoms of Crohn’s disease and ulcerative colitis can be similar to those of bowel cancer.
These include:
- Diarrhoea
- Fever and fatigue
- Pain and cramping in the tummy
- Blood in the stool
- Poor appetite
- Unintended weight loss.
If you or a family member suffers from any of these symptoms, it’s important to get them checked by a doctor. Even if the diagnosis is not bowel cancer, it may still be a case of IBD.
The other thing to consider is that IBD can raise your risk of bowel cancer.
This is because chronic inflammation in the gut may lead to an abnormally high turnover of cells in the intestinal lining. As old cells are replaced with new cells, there’s the risk of abnormalities that may lead to bowel cancer. So, people with IBD are considered to be at a higher risk of developing bowel cancer around 8 to 10 years after they first start experiencing inflammation in the gut.
It’s important to note that most people living with IBD will never develop bowel cancer. And if they do, it is 90% treatable when detected early.
What is Crohn’s Disease?
Crohn’s disease is an autoimmune condition that causes inflammation of the digestive tract. It usually occurs in the last section of the small intestine or the colon (large intestine) but can also affect the stomach or even the mouth.
In moderate or severe cases, the inflammation can thicken the intestine, causing blockages. There may be scar tissue which also obstructs the passage of food.
The exact cause is unknown, but genes, environmental factors and previous infections may be involved. Smokers are more likely to develop the disease than non-smokers, and their symptoms are usually more severe. Crohn’s disease is slightly more common in women than men. There may be long periods with no symptoms, only for the condition to flare up in the future.
If you are diagnosed with Crohn’s disease you should be monitored regularly in case bowel cancer develops. Some studies suggest that people with Crohn’s disease are twice as likely as the general population to develop bowel cancer.
What is ulcerative colitis?
Ulcerative colitis is different from Crohn’s disease, in that it’s usually found in just the inner lining of the gut and only affects the colon and rectum.
The symptoms are similar because both conditions involve inflammation that may cause abdominal pain, diarrhoea, discomfort, bleeding and weight loss. A full medical investigation should be able to tell you which form of IBD you have – and exclude bowel cancer.
As with Crohn’s disease, the cause is hard to pin down. Genes, environmental factors and an over-active immune system may be involved. Ulcerative colitis affects both men and women equally and is most likely to develop between the ages of 15 and 30 – although it can appear at any age. Symptoms are often worse in the morning. Some people may go months or years without symptoms but then experience flare-ups.
The longer you have ulcerative colitis, the greater your risk of bowel cancer. After 10 years the risk is 1 in 50 but after 30 years the risk is 1 in 6. For this reason, everyone with ulcerative colitis should have regular monitoring and check-ups.
What are the treatments for IBD?
As with many autoimmune conditions, there is no simple ‘cure’ for IBD. It’s a case of taking the prescribed medications, eating a healthy diet and managing your symptoms. Your GP or specialist will give you advice and help you minimise the effects of Crohn’s disease or ulcerative colitis.
If you are living with IBD, you need to be aware of how it may affect your risk of developing bowel cancer in future years. Ask your GP or specialist about a regular screening programme.
Make notes of your symptoms and any concerns, and don’t be afraid to raise them with your doctor. Remember that the warning signs of bowel cancer and IBD can be very similar – so it’s important to be ‘bowel cancer aware.’
If a family member develops bowel cancer, make an appointment with your GP or specialist to see whether you need more frequent bowel cancer checks.
More information and support.
Crohn’s & Colitis New Zealand has a detailed website with information and resources for patients and caregivers.
You can download their handbook – Living with IBD – or ask your specialist for a free copy.
This 3-minute video provides an overview for IBD patients who want to minimise their risk of bowel cancer.