Understanding Bowel Cancer: Key Symptoms, Prevention, and Treatment Insights with Dr Carolyn Bariol

Bowel cancer is the third most common cancer in Australia, yet many people remain unaware of its symptoms and the importance of early detection. We spoke to Gastroenterologist, Dr Carolyn Bariol about symptoms, treatment options and myths of Bowel Cancer.  


What are the key symptoms of Bowel Cancer?

Many people with bowel cancer have no symptoms at all. The new onset of bleeding from the bowel, or a changing bowel pattern means you should seek medical attention, regardless of your age. Advanced bowel cancer can cause abdominal pain, anaemia and fatigue.

How can bowel cancer be prevented?

A healthy lifestyle plays an essential role in bowel cancer prevention. Lifestyle factors such as smoking, drinking excess alcohol, obesity, and consumption of processed meats such as bacon and salami will increase your risk. Moreover, exercising and reducing your intake of red meat will help to minimise risk. 

What screening can be done?

At-home bowel screening tests can detect microscopic amounts of blood that are not detectable to the naked eye. The Government Bowel Cancer Screening program is free, and kits are sent to those aged between 45 and 74 years. Your GP can organise screening outside of these ages through Bowel Screen Australia. The presence of blood can indicate an advanced polyp or an early cancer that can be treated before becoming very serious. Colonoscopy is a test used for screening in people who have concerning symptoms or a family history of bowel cancer. 

What are the treatment options for early detection versus late detection?

Early detection can often mean that small polyps or tumours are treated without major surgery or chemotherapy. Advanced cancers detected later will need more detailed or prolonged therapies. 

Is there a multidisciplinary approach to treatment?

When a patient is diagnosed with bowel cancer, a team of doctors, including a surgeon, an oncologist, a pathologist and allied health practitioners will work together to plan the best management for each individual. St Vincent’s Campus prides itself on excellent communication and teamwork within our healthcare teams. 

Is there new research or technology being used to prevent or treat this type of cancer?

Early detection has recently been enhanced with the addition of AI (artificial intelligence) used as part of new colonoscopy technology. This has been shown to increase the detection of precancerous polyps in the colon. The Diagnostic Endoscopy Centre at St Vincent’s Clinic is one of the few clinics in Australia who has already adopted this new technology. Colonoscopic and surgical techniques have improved significantly over the last decade, making treatments more successful and less invasive for patients with bowel cancer. Some small cancers can be removed at the time of colonoscopy while more advanced cancers can be removed using keyhole or robotic surgery. The use of different additional therapies including immunotherapy are providing improved outcomes in selected cancers also.

Are those with Irritable Bowel Disease at a higher risk of BC?

Irritable bowel syndrome (IBS) is a benign condition. Some patients with IBS have severe and debilitating symptoms but fortunately, IBS is not a precancerous condition.

Are there any misconceptions about this disease?

Many patients with irritable bowel syndrome have abdominal pain and altered bowel pattern. They may require a colonoscopy to rule out bowel cancer. Patients with irritable bowel syndrome do not have rectal bleeding. Bleeding from the bowel regardless of age should never be ignored.

What procedures can be done to prevent or manage this disease?

Irritable bowel syndrome is a functional disease of the colon. Investigations should take place to rule out pathological causes for the symptoms. Once other diseases have been excluded, the management of irritable bowel syndrome aims at improving bowel function, often by avoidance of specific triggers, such as different food types and stress.

Does diet matter?

Dietary triggers play a very important role in symptoms associated with irritable bowel syndrome. Sometimes, even healthy foods can exacerbate abdominal pain, bloating and altered bowel pattern. Gastroenterologists are generally very good at providing advice about this. Sometimes, an accredited dietitian is also involved in the care of patients with IBS.

Is there anything new or interesting that the Diagnostic Endoscopy Centre is doing to combat, assist to treat this disease?

There is now good evidence that dietary triggers and psychological factors have an important role in the development of symptoms and help guide management of IBS. Gastroenterologists work closely with allied health providers including psychologists and dietitians to help with these triggers. There are also excellent digital resources available, which are useful.

And finally…

Bowel cancer screening has been proven to reduce the occurrence of bowel cancer. Screening and early detection improves outcomes of treatment and reduces the number of deaths due to bowel cancer. In Australia, less than 50% of people participate in the Government Bowel Cancer Screening Program. If more people used the home bowel kit, there would be less bowel cancers

If you have concerns, speak to your GP and visit Bowel Cancer Australia.

Dr Carolyn Bariol is a Gastroenterologist at the Diagnostic and Endoscopy Centre at St Vincent’s Clinic. Dr Bariol completed her medical degree at UNSW and undertook her junior resident and basic physician’s training at St Vincent’s Hospital, Darlinghurst.

She completed Masters of Science with a focus on genetic study into the precursors of colon cancer at the Garvan Institute and specialises in Inflammatory Bowel Disease, Coeliac Disease and colorectal cancer screening.