Can frequent constipation lead to colorectal cancer? Colorectal cancer is more likely to affect these people. Let's see if you are one of them!

gossip

When it comes to constipation, many people have this secret, and there are many rumors circulating on the Internet that " long-term constipation can lead to rectal cancer ", which makes many people worried. So, is this rumor true?

analyze

What is rectal cancer? Rectal cancer refers to the cancer between the dentate line and the junction of the rectum and sigmoid colon. It is one of the most common malignant tumors of the digestive tract .

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The rectum is a 12-15 cm long section of the digestive tract inside the anus, with the end directly connected to the anus. Don't underestimate it, as it is only 12-15 cm long, less than the length of a chopstick, but cancer occurring here is a common malignant tumor in the gastrointestinal tract, with an incidence rate second only to gastric cancer and esophageal cancer.

The vast majority of rectal cancer patients are over 50 years old, with more men than women. Rectal cancer in Chinese people mostly occurs in the middle and lower rectum .

What are the clinical manifestations of rectal cancer ?

1. Changes in bowel habits, such as increased frequency of bowel movements, alternating diarrhea and constipation;

2. Changes in stool characteristics, such as stool becoming thinner, flatter, or grooved, or mucus or blood in the stool;

3. Defecation is difficult, there is a feeling of defecation, but no stool is released. Many people think this symptom is just ordinary "constipation";

4. Abdominal pain symptoms, which may be persistent dull pain, or abdominal pain radiating to the anus, or abdominal discomfort or bloating;

5. Abdominal mass;

6. Systemic symptoms may include fever, anemia, weight loss, fatigue, etc.

Among them, blood in the stool, increased frequency of bowel movements, and thinning stools are common symptoms of rectal cancer .

Can frequent constipation lead to colorectal cancer ?

Let me give you the answer first: long-term constipation will not lead to the occurrence of colorectal cancer, nor is it a clear high-risk factor for colorectal cancer .

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Constipation is a general term for decreased frequency of bowel movements (less than 3 bowel movements per week), reduced stool volume, dry stool, and difficulty in defecation. Strictly speaking, it is not a disease itself, but a clinical symptom.

Constipation is a symptom of colorectal cancer, but constipation does not cause colorectal cancer . Moreover, compared with patients without constipation, the incidence of colorectal cancer in people with long-term constipation is not higher, so constipation is not a high-risk factor for colorectal cancer.

Although constipation is not a high-risk factor for rectal cancer, it is a clinical manifestation of rectal cancer . That is to say, after suffering from rectal cancer, as the disease progresses, patients will experience symptoms of difficulty in defecation or changes in bowel habits.

Which groups of people are more susceptible to rectal cancer ?

▶ First-degree relatives have a history of colorectal cancer (including non-hereditary colorectal cancer family history and hereditary colorectal cancer family history)

Studies have shown that the risk of colorectal cancer in people whose first-degree relatives have it is 1.76 times that of the general population, and the effect of family history on the risk of colorectal cancer is also affected by the number of relatives with the disease.

▶ The patient has a history of colorectal cancer, intestinal adenoma, or long-term inflammatory bowel disease for more than 8 to 10 years

① People with a history of colorectal cancer are more likely to have recurrence and metastasis after surgery, which is related to some characteristics of the tumor itself: for example, the depth of tumor infiltration into the intestine and the number of lymph node metastases are the most important factors affecting postoperative recurrence and metastasis.

The risk of postoperative recurrence of rectal cancer is higher than that of colon cancer. The operating space for rectal cancer surgery is limited, so the incidence of local recurrence after surgery is significantly higher than that of colon cancer.

Gene mutations and immune characteristics also have a significant impact on the prognosis of colorectal cancer. For example, those with RAS and BRAF gene mutations are prone to recurrence.

② Patients with a history of colorectal adenoma are more likely to develop colorectal adenoma or even colorectal cancer again than the general population.

Research suggests that more than 80% of colorectal cancers evolve from adenomas, and it usually takes 5-10 years for colorectal cancer to develop from adenomas to the late stage. Therefore, if adenomas are found during examination, it is recommended to remove them.

③The onset of inflammatory bowel disease is related to chronic inflammation of the intestinal mucosa, including ulcerative colitis (UC) and Crohn's disease. The main pathogenesis pattern is inflammation → dysplasia → tumor.

As the course of the disease increases, the risk of cancer in UC patients increases. Studies have reported that the risk of cancer in UC patients increases by 0.3% with each year of disease progression.

▶ People who consume red meat and processed meat for a long time

Long-term intake of red or processed meat is associated with an increased risk of colorectal cancer.

For every 50g increase in daily processed meat intake, the risk of colorectal cancer increases by 16%;

For every 100g increase in daily red meat intake, the risk of colorectal cancer increases by 12%.

▶ People with diabetes, obese people, smokers, and heavy drinkers

Diabetic patients : The risk of tumor development in diabetic people is 3-4 times that of non-diabetic people.

Because the ability of tumor cells to metabolize glucose is about 10 times that of ordinary cells, the large amount of glucose in the body of diabetics provides sufficient nutrition to the tumor cells, allowing them to grow wildly.

Obese people : Increased insulin levels promote cell growth and inhibit cell apoptosis, which is associated with an increased risk of colorectal cancer. In addition, obesity can also stimulate the body's inflammatory response, which can promote the development of colorectal cancer.

Long-term smokers : Compared with non-smokers, smokers have a higher risk of colorectal cancer, and the risk increases with the number of years of smoking and the number of cigarettes smoked. The reasons may be that smoking affects the body's immunity, carcinogens produced by tobacco combustion, affects the stability of chromosomes, and causes mutations in oncogenes and tumor suppressor genes.

People who drink a lot : When drinking for a long time, excessive intake of harmful substances will cause damage to the intestinal mucosa, thereby affecting the normal functioning of the intestines and inducing colon cancer.

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How to prevent colorectal cancer ? Do these four things !

An unhealthy lifestyle is the main cause of colorectal cancer. We can do the following in our daily lives:

1. Adhere to physical exercise, such as running, brisk walking and other aerobic exercises to increase your own resistance and avoid obesity;

2. Adhere to a healthy diet, increase the intake of dietary fiber, whole grains, and dairy products, avoid high-fat diets, promote intestinal peristalsis, and maintain smooth bowel movements;

3. Persist in quitting smoking and limiting alcohol consumption to avoid long-term inflammatory stimulation to the digestive tract;

4. Adhere to regular physical examinations and participate in early screening for rectal cancer. People at high risk need to undergo further diagnostic colonoscopy.

What is the starting age for colorectal cancer screening ?

The Guidelines for Colorectal Cancer Screening, Early Diagnosis and Treatment in China (2020, Beijing) recommends that the starting age for colorectal cancer screening is:

1. People at average risk should undergo colorectal cancer risk assessment starting at age 40;

2. People with low to moderate risk should receive colorectal cancer screening between the ages of 50 and 75;

3. People at high risk should receive colorectal cancer screening between the ages of 40 and 75. If one or more first-degree relatives have colorectal cancer, the recommended starting age for colorectal cancer screening is 40 years old, or 10 years earlier than the youngest patient among the first-degree relatives.

4. The screening age for people at high risk of hereditary colorectal cancer should start and end earlier, and screening should continue throughout their lives.

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in conclusion

Constipation may be a symptom of rectal cancer. Long-term constipation itself does not cause rectal cancer, but it may be the intestines "calling for help". When there are persistent changes in bowel habits, constipation or abnormally colored stools, remember to go to the hospital for examination in time.

Author : Hu Zhongdong, deputy chief physician, registered dietitian, health manager, and speaker of the Healthy China Action

Reviewer : Wang Qiang, deputy chief physician, Department of Gastroenterology, Peking Union Medical College Hospital

Planning丨Zhong Yanping

Editor: Zhong Yanping

Layout by Li Mengxin

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