I have been in the doctor for more than 20 years. Due to my work, I have encountered many patients with colorectal cancer. Most of them are middle-aged and elderly people. The clinical manifestations of these people are different. Some of them are early stage of colorectal cancer and some are advanced. . In order to give everyone a preliminary understanding of colorectal cancer, here is a review of the performance of patients with colorectal cancer at the first diagnosis.
One. Blood in the stool is the earliest manifestation of colorectal cancer:
Due to the influence of the folk saying "ten people with nine hemorrhoids", some people do not go to a regular hospital for blood in the stool for examination, but buy some hemorrhoid medicine for external application, or go to an informal medical institution for treatment, often misdiagnosing rectal cancer as internal hemorrhoids occur. I met a middle-aged woman in the outpatient clinic. She had blood in the stool more than a year ago. At that time, she didn't care about it. Six months ago, she went to a private hospital because of hemorrhoids. The doctor said that she had hemorrhoids and treated her with surgery. For six months after the operation, she still had blood in the stool every day. , There is mucus, pus and blood in the stool, and gradually have more bowel movements, frequent loosing and poor discharge, and difficulty in defecation. I performed a digital anus examination on the patient, and a hard cauliflower-like mass was palpable 8 cm into the finger, and the intestinal cavity was narrow. After the diagnosis, the finger was bloody and smelly. The patient's rectal cancer is in the advanced stage.
Once a middle-aged person came to the doctor and said that he had a watermelon-like bloody substance sprayed on his underwear when he was exhausted today. I asked him to check it. The digital examination found that there was a large swelling in the anus about 7 cm from the anus. , Pathological diagnosis of rectal cancer. Now it has been more than two years since the patient has undergone radical surgery for rectal cancer and is still very good.
Tips: Internal hemorrhoids often appear intermittently with blood in the stool, some months or years apart, as long as the stool is clear, the blood in the stool usually disappears within two weeks, the blood in the stool is bright red, showing bleeding or ejection, and the blood does not mix with the stool. Colorectal cancer blood in the stool lasts for a long time, or blood in the stool every three to five times, or pus, blood and mucus. When a doctor encounters a patient with blood in the stool, he must do a digital anal examination. Rectal cancer usually occurs within 8-10 cm from the anus. Touched.
two. Change bowel habits to be alert to intestinal tumors
Once chatting with a colleague, she said that she had irregular bowel movements recently, and her stools became thinner, and she still had mucus 2 to 3 times a day. I asked her to check for fecal occult blood three times (within a week) and two times were positive. I advised her to have a colonoscopy. She listened to my advice and did an examination, and found that there was a puffy mass in the sigmoid colon, which was confirmed to be an early stage colon cancer after the operation. I also often encounter patients who come to see a doctor with diarrhea, abdominal pain, pus and blood in the stool. Colonoscopy has some ulcerative colitis and some colon tumors.
Tip: Those who have changed bowel habits must be diagnosed by colonoscopy first, otherwise the treatment of colon inflammation will often delay the condition. Some colon cancers are also the result of colon inflammation or colon polyps.
three. Constipation may also be a narrowing of the intestinal cavity caused by cancer
Most people attach great importance to blood in the stool, and go to the hospital for examination as soon as they have symptoms, for fear of rectal cancer. But I don’t pay much attention to constipation. When I get constipation, I buy some laxatives to relax my bowels. If my symptoms are temporarily relieved, I don’t go to the hospital for further examination. An elderly female patient suffered from constipation six months ago and often took some laxatives on her own. Now, the old lady has difficulty defecation, always intends to defecate but can't pass stool after going to the toilet. Sometimes the stool is still one by one, but there is no blood in the stool. . When I checked the patient and told her daughter about the clinical diagnosis, her daughter said, "Why does my mother not have blood in the stool, but only have difficulty in defecation, and constipation. Is rectal cancer still in the advanced stage? I explained: the blood in the stool is not visible to the naked eye, which may be due to the low amount of bleeding. If the stool occult blood test is often positive, because the malignant tumor grows faster and the blood supply is not available, the local tissue will be bleeding and necrosis, and the patient may have pus in the stool. Bloody secretions, the tumor enlarges to a certain degree and the symptoms of obstruction appear, the stool becomes deformed and thin, and it is difficult to discharge.
Tip: Constipation is a common clinical symptom and an important cause of many diseases. There are a variety of toxins in the stool, which will have a serious impact on the human body after being absorbed. The onset of colorectal cancer and constipation are one of the reasons, and it is also the manifestation of the tumor's enlarged intestinal cavity.
four. Abdominal pain and anemia should pay attention to whether colon occupying lesions
A female patient with anemia was only 40 years old. A year ago, hemoglobin decreased. She was diagnosed with iron deficiency anemia after blood transfusion and iron preparations. The anemia improved a bit after taking iron preparations. Hemoglobin decreased rapidly after a short time. To find out the reason, I performed a colonoscopy for her and found that there was a tumor in the liver area of the colon. The tumor was large and it was difficult to pass the colonoscopy. When reviewing his condition, the patient said that during the past year, he often had pain in the left abdomen and sometimes in the right abdomen, with paroxysmal colic or dull pain, combined with loss of appetite, fullness, belching, nausea and vomiting, etc., which he considered to be gastrointestinal discomfort caused by medication. Did not care.
Tips: Due to the large intestinal cavity, the stool in the intestine is liquid. The cancer in this section of the intestine is mostly ulcer or cauliflower. The cancer often ulcerates and hemorrhages, secondary infection, accompanied by toxin absorption, so there are many patients. He was diagnosed with abdominal pain, anemia, and abdominal mass.
Fives. Stool occult blood test is the simplest and most feasible method to detect intestinal tumors
There was a patient who was hospitalized with a medical disease. The fecal occult blood test continued to show positive results. I performed a colonoscopy on the patient. No new intestinal organisms were seen through the lens 120 cm. I asked the patient to do a barium enema. Finally A space-occupying lesion was found in the cecum.
Tip: Stool occult blood test is a common method for clinical screening of patients with unobvious symptoms whether they need further colonoscopy or barium enema. This test is often used for colon cancer screening abroad. If multiple tests are positive, the patient should be given a colonoscopy or barium enema. In order to confirm the diagnosis