Beating bowel cancer

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In the June issue of Retail Pharmacy Assistants e-magazine, we explored bowel health and the importance of resuming regular screening programs and efforts to raise awareness around one of the deadliest conditions in the world – colorectal cancer.

What is a healthy gut?

“There is no one definition of a healthy gut,” Accredited Practising Dietitian and spokesperson for Dietitians Australia Nicole Dynan said, “but looking at our stools can give us a good indication of the health of our gut.”

She adds that the gut does more than simply digest food.

“It’s linked to our physical and mental health and a myriad of other health conditions, so it’s important that we look after it so that it can help look after us,” she said.

Pharmacy Assistant of the Year Award national winner for 2021 Ashleigh Hutson says that looking after your bowel health will not only help avoid preventable colon issues but also help in maintaining a healthy lifestyle.

“A poor digestive system can make you feel bloated and sluggish, and can cause other ongoing health problems,” she said.

Inspecting stools is one way to monitor bowel health. Ms Dynan says indicators of poor bowel health include stools that are dry, hard, bally, loose or watery.

“Our stools should be well-formed, solid, and easy to pass,” she said. “Other symptoms such as pain, blood in the stool or excessive gas should be investigated.”

Ms Hutson says signs and symptoms that indicate poor bowel health include bloating, constipation and digestion discomfort.

“Irregular bowel movements, including discomfort when trying to pass, and signs of blood in stools [also indicate poor bowel health],” she said, adding that extreme weight loss and unexplained fatigue are also signs of potential cancer risk.

The importance of regular screening

Ms Dynan says that while the risk of developing bowel cancer greatly increases with age, particularly from age 50, regardless of age, “ignoring symptoms such as abdominal pain, bleeding from the bowel or changes in bowel habits may increase your risk of complications and even death”.

She underscores the need for bowel screening every two years from the age of 50, to minimise this risk.

“This is important if you have a personal family history of bowel cancer, because, if it’s caught early, the chances of successful treatment and long-term survival improve significantly,” Ms Dynan said.

Ms Hutson also emphasises the importance of regular screening, agreeing that the frequency should be every two years from the age of 50, to reduce the risk of bowel cancer.

“The test can detect small amounts of blood in the stool, which can be a tell-tale sign of bowel cancer,” she said. “Detecting it early, nine out of 10 cases can be treated successfully.”

She adds that free test kits are sent to Australians from the age of 50, and they can also be purchased at most local pharmacies.

Bowel health through diet 

“Diet can make a noticeable impact on the microbiota in less than 48 hours,” Ms Dynan said. “So, it’s never too late to improve the quality of your overall diet.”

She adds that “diet is one of the easiest and most accessible tools we currently have” to positively impact our bowel health.

Ms Hutson agrees.

“Diet plays an important role in maintaining a healthy bowel, she said.”

She recommends a balanced diet that includes fibre, a moderate amount of lean meats or meat alternatives, and dairy.

“Eating small and regular meals can also help keep the bowel regular,” Ms Hutson said.

“Eating fruit, vegetables and wholegrain cereals has been associated with reduced risk of certain cancers.”

Health experts agree that ensuring adequate fibre intake is one of the most important considerations when it comes to maintaining bowel health.

Consuming plenty of vegetables and fruit, legumes/lentils, whole grains and nuts and seeds will increase fibre.

“All types of fibre are useful in maintaining a healthy bowel,” Ms Dynan said. “Some [types of fibre] help to bulk up the stool and keep things moving. Others support healthy microbes in the gut via a prebiotic effect.”

Regarding probiotics, while it’s commonly thought that a general probiotic can be beneficial for bowel health, Ms Dynan says an important factor is the strain of bacteria found in the probiotic.

“Probiotic use is in its infancy and benefits come down to particular strains,” she said, pointing to a guide to probiotic strains for certain health conditions from the US organisation AEProbio (available here: usprobioticguide.com)

Ms Hutson adds that probiotics play a significant role in maintaining bowel health because they provide “good bacteria to the gut, which aids digestion and helps maintain gut health.”

“The good bacteria found in probiotics helps aid in preventing and treating illness,” she said.

While it’s perhaps a commonly held belief that diet is implicated in the occurrence of other uncomfortable bowel symptoms, such as flatulence, for example, Ms Dynan says “excessive or particularly smelly flatulence may be a sign that something else is going on”.

“Flatulence and bloating may be symptoms associated with constipation,” she said.

“A pharmacy assistant and pharmacist can be of great help here, recommending laxatives or other products such as psyllium [the main ingredient in Metamucil] or Iberogast to improve motility or for symptom relief. This is where a dietitian may also come in handy, to help resolve the underlying dietary causes of the problem.”

The role of a pharmacy assistant

Ms Hutson says pharmacy assistants play an important role in assisting customers with their bowel health needs.

“We can help advise you on lifestyle choices that can affect your bowel health and help you create a healthier future,” she said.

Pharmacy assistants, she adds, are highly trained in advising and selling OTC medications.

“We have great access to information hubs for more information to send patients home with and can also help assist patients on the right pathway if they need more specialised resources and tests,” Ms Hutson said.

For more about bowel health and screening, visit: bowelcanceraustralia.org.