Rhiannon Ingle
We're just a matter of days away from Bowel Cancer Awareness Month, which lands in April in the UK.
General surgeon Ali Cadili explains that this time serves as a 'crucial reminder' that early signs of the disease are often easy to miss.
"If you’re ignoring subtle changes in bowel habits, unexplained fatigue, or abdominal discomfort, you’re doing yourself a disservice," he warns. "Spotting these warning signs early can be lifesaving."
Cadili adds: "Acting quickly is far more important than hoping the symptoms will pass."
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So, without further ado, here are the five bowel cancer warning signs that are often overlooked.
Cadili recommends checking the toilet paper, the bowl, and the surface of the stool for 'bright red streaks, maroon smears, or black, tar‑like stools'.
Additionally, you should note whether bleeding appears with bowel movements, after wiping, or mixed within the stool, as urgent medical assessment is warranted if bleeding is heavy, recurrent, accompanied by dizziness or faintness, or if stools look black and sticky.
In adults under 50, rectal bleeding carries a higher risk and isn’t automatically haemorrhoids.
The surgeon also urges people to look for stools that are 'narrower than usual, loose, mucus‑coated, or pale, maroon, or black'.
He adds: "It helps to note whether this becomes the pattern rather than an occasional upset, and whether bowel habits swing between diarrhoea and constipation.
"Medical review is urgent when ongoing change pairs with abdominal pain, rectal bleeding, unexplained weight loss, or iron‑deficiency anaemia."
Cadili advises noting 'where discomfort sits, what it feels like, and whether it eases after a bowel movement or keeps returning'.
According to the expert, you need to watch for pain that wakes a person at night, progressive bloating, or a sense of incomplete emptying after toilet visits.
"Urgent assessment is appropriate when pain occurs with rectal bleeding, vomiting, fever, marked abdominal swelling, or inability to pass wind or stool," he notes.
"When combined with another red‑flag symptom, this pattern increases concern for bowel cancer rather than simple indigestion."
The surgeon says that people should check for 'looser‑fitting clothes, a falling belt notch, or a noticeable drop in appetite without trying to lose weight'.
You can compare your current weight with a recent usual weight using the same scales and similar clothing.
"Red flags include weight loss alongside bowel changes, ongoing fatigue, or abdominal pain, as this combination can reflect internal disease activity," Cadili says. "Rapid decline, dehydration, or weakness that limits daily tasks elevates urgency for prompt medical review."
And the final warning sign is persistent fatigue.
"Look for tiredness that lingers, pale skin or eyelids, headaches, or shortness of breath on stairs," Cadili recommends. "Hidden bowel bleeding can slowly drain iron, so pairing fatigue with darker stools, rectal bleeding, or new bowel changes raises concern."
According to the surgeon, urgent evaluation is appropriate if fatigue comes with chest pain, racing heartbeat, severe lightheadedness, or fainting, or if known iron levels stay low despite supplements.
"Multiple red‑flag symptoms together amplify risk and warrant early investigation," he concludes.
You can find out more about bowel cancer on the official NHS website.
If you’ve been affected by any of these issues and want to speak to someone in confidence, contact Macmillan’s Cancer Support Line on 0808 808 00 00, 8am–8pm seven days a week.