As the other carcinomas of the body, colorectal carcinoma is a disease of old age. If it occurs in younger age the prognosis is poor.
The patient usually does not come to a doctor before 6 months of commencement of the disease.
- The main symptom is bleeding per rectum. This is the most constant and earliest symptom. There may be mucus along with bleeding. The bleeding is usually slight in amount and occurs with the stool or at the end of defecation. It is sometimes seen as spot in tissue paper or may stain the under-clothing.If a careful history is taken one may differentiate between bleeding from internal pile and bleeding due to cancer. It must be noted that it is a painless bleeding like an uncomplicated internal pile.
- Alteration of bowel habit is a very common symptom. Earlier it may be an increasing constipation or it is in the form of early morning diarrhea. In case of annular carcinoma at the pelvi-rectal junction the patient suffers from increasing constipation. Instead of taking advice from his doctor the patient prefers to take increasing dose of laxatives. Ultimately, with the use of laxatives he shows a tendency towards diarrhea for a limited period of time, which is again followed by constipation once the patient stops taking laxatives.This is called alteration in bowel habit.
Other Symptoms And Signs Of Colorectal Carcinoma
- The other symptom is early morning diarrhea. The patient gets up from bed to rush to the toilet. The patient passes lots of blood and mucus in addition to feces. This is particular symptom seen in case of cauliflower like growth at the ampulla of the rectum.
- Sense of incomplete defecation is quite common when a papilliferous or proliferative growth is situated at the lower half of the rectum. Every time the patient opens his bowel, he feels that more feces are to be passed. So he visits the toilet frequently (spurious diarrhea or false diarrhea). But he fails to pass formed stool, instead he passes flatus and a little blood stained mucus (bloody slime).
- Pain is a late symptom. Only with intestinal obstruction due to stenosing growth of the recto-sigmoid junction one may suffer from colicky pain from intestinal obstruction. When the growth has come out of the rectum and the surrounding structures are involved and the patient complains of pain. Sciatica may be complained of when the growth has invaded the sacral plexus.
- A few patients may present with bizarre symptoms like loss of weight, slight pain and symptom associated with distant metastasis. These are palpable lump of live metastases. These are palpable lump of liver metastasis, yellowness of jaundice and abdominal distension from ascites.