gastrointestinal disorders
Colorectal Cancer
Symptoms and Signs of Colorectal Cancer
Colorectal adenocarcinomas grow slowly, and a long interval elapses before they are large enough to cause symptoms. Symptoms depend on lesion location, type, extent, and complications. The right colon has a large caliber and a thin wall and its contents are liquid; thus, obstruction is a late event. Bleeding is usually occult. Fatigue and weakness caused by severe Evaluation of Anemia may be the only complaints, and tumors are often asymptomatic and are detected only when colonoscopy or cross-sectional imaging is done for another reason. Tumors sometimes grow large enough to be palpable through the abdominal wall before other symptoms appear. The left colon has a smaller lumen, the feces are semisolid, and cancer tends to cause obstruction earlier than in the right colon. Partial obstruction with colicky abdominal pain or complete obstruction may be the initial manifestation. The stool may be streaked or mixed with blood. Some patients present with symptoms of perforation, usually walled off (focal pain and tenderness), or rarely with diffuse peritonitis. In rectal cancer, the most common initial symptom is bleeding with defecation. Whenever rectal bleeding occurs, even with obvious Hemorrhoids or known Some patients first present with symptoms and signs of metastatic disease (eg, hepatomegaly, Ascites , supraclavicular lymph node enlargement). 