Many people brush off constipation, blood in the stool, or sudden changes in bowel habits as “just something I ate.” But for some, like 48-year-old office worker B. Pattnaik, these were the first whispers of colorectal cancer. One ordinary workday, he felt queasy after lunch, went to the washroom, noticed bloody stools, became dizzy and collapsed. Fortunately, his colleagues rushed him to a hospital — and that quick action may have saved his life.


Colorectal cancer (cancer of the colon or rectum) is one of the most treatable cancers when caught early. In Stage I, five‑year survival rates can be as high as 90–95%. Yet too many people are diagnosed only when the disease has advanced, making treatment more complex and outcomes less certain. This article walks you through the subtle signs we often miss, what’s normal versus concerning, and how you can protect yourself and your loved ones.


Illustration of colon highlighting colorectal cancer risk areas
Early-stage colorectal cancer often starts with quiet, easy-to-miss changes in how your gut behaves.

Why colorectal cancer is often missed in people under 50

Colorectal cancer has traditionally been considered a disease of older adults, but in the last decade, doctors worldwide have reported a steady rise in cases among people in their 40s — and even 30s. Many of them are otherwise healthy, working full-time, and juggling family responsibilities, just like Pattnaik.


The challenge is that early colorectal cancer often:

  • Starts with vague, mild symptoms that resemble common gut issues
  • Comes and goes, leading people to think the problem has “resolved”
  • Appears in younger adults who are not yet on routine screening schedules

“When detected at Stage I, colorectal cancer is highly treatable, with five-year survival rates around 90–95%. The tragedy is that many patients come to us only when symptoms have been present — and ignored — for months.”
— Gastrointestinal Oncologist, tertiary care hospital


Early signs and symptoms of colorectal cancer we often dismiss

Not every tummy issue is cancer — far from it. But there are patterns that should prompt you to see a doctor. Here are the main warning signs, with a focus on the ones most often overlooked.


1. Sudden, unexplained changes in bowel habits

Pattnaik’s story began with constipation and a sudden change in his gut rhythm. You know your usual pattern — whether it is once a day or every other day. Be cautious if you notice:

  • New or worsening constipation lasting more than 2–3 weeks
  • Unusual diarrhoea that doesn’t settle or keeps returning
  • A feeling that your bowel does not empty completely
  • Narrow or “pencil-thin” stools

2. Blood in stool — visible or hidden

Bright red blood on the toilet paper, in the bowl, or mixed with stool is alarming but easy to brush off as piles (haemorrhoids). While piles are common, they should not automatically be blamed without a proper examination, especially if:

  • The bleeding is new or different from what you have had before
  • You also have changes in bowel habits or abdominal discomfort
  • You feel tired, dizzy, or notice unexplained weight loss

Some people have occult (hidden) blood in their stool that is not visible to the eye but shows up on lab tests. This can gradually lead to anaemia.


3. Persistent abdominal discomfort

Gas, cramping, and bloating are common after heavy or spicy meals. But when:

  • Pain or cramps keep recurring
  • You feel a constant fullness or pressure in the lower abdomen
  • Discomfort wakes you at night or affects daily activities

it is worth getting evaluated. Persistent discomfort, especially combined with bowel changes, should not be ignored.


4. Unexplained fatigue or anaemia

Slow blood loss from a tumour in the colon can lead to iron‑deficiency anaemia. Symptoms include:

  • Feeling unusually tired despite adequate sleep
  • Shortness of breath on mild exertion
  • Pale skin or frequent dizziness

5. Unintentional weight loss or loss of appetite

If you are not trying to lose weight but notice your clothes are looser, or you simply do not feel like eating, this may signal an underlying problem — including possible cancer.


Person holding their lower abdomen, indicating bowel discomfort
Bowel changes that persist for weeks — especially if new for you — deserve medical attention, regardless of age.


A relatable case: from “just constipation” to a cancer diagnosis

While every patient’s story is unique, aspects of Pattnaik’s experience are familiar to many clinicians. For weeks, he had noticed that:

  • He was more constipated than usual
  • He needed to strain to pass stool
  • His abdomen sometimes felt bloated after meals

Busy with work, he attributed it to “desk job life” and irregular eating habits. It was only when he passed bloody stools at work, felt dizzy, and collapsed that he landed in the emergency room. Investigations, including a colonoscopy, revealed a growth in his colon that turned out to be cancer.


Thankfully, he was diagnosed at a stage where surgery and further treatment offered a realistic chance of cure. But doctors involved in such cases frequently share a similar reflection: symptoms had been present — and dismissed — for much longer than the patient realised.


“Many patients later tell us, ‘Doctor, in hindsight I did have constipation and changes for months, but I thought it was nothing.’ Listening to your body and seeking help early can literally change the stage at which we find the cancer.”
— Senior Colorectal Surgeon


Who is at higher risk of colorectal cancer?

Colorectal cancer can affect anyone, but certain factors increase the risk. Recognising these helps you decide how proactive you should be about screening.


Non-modifiable risk factors

  • Age: Risk increases after 45–50, but younger adults are not exempt.
  • Family history: A parent, sibling, or child with colorectal cancer or advanced polyps.
  • Genetic syndromes: Such as familial adenomatous polyposis (FAP) or Lynch syndrome.
  • Personal history: Previous colorectal polyps, inflammatory bowel diseases (ulcerative colitis, Crohn’s disease).

Modifiable risk factors

  • Low-fibre, high-fat or highly processed diets
  • Regular consumption of red or processed meats
  • Physical inactivity and prolonged sitting
  • Obesity, particularly central (abdominal) obesity
  • Smoking and heavy alcohol use

Doctor discussing colorectal risk factors with a patient
Understanding your personal risk profile helps tailor when to start screening and how often to repeat it.


Why early detection matters: survival rates and treatment options

Colorectal cancer usually develops slowly over years, often starting as benign polyps that later turn cancerous. This slow progression is actually good news — it means there is a long window for detection and intervention.


  • Stage I: Cancer is limited to the inner layers of the colon/rectum. Five‑year survival rates are around 90–95%. Surgery alone is often sufficient.
  • Stages II–III: Cancer has grown deeper or spread to nearby lymph nodes. Treatment may include surgery, chemotherapy, and sometimes radiation. Outcomes are still significantly better than in Stage IV.
  • Stage IV: Cancer has spread to distant organs (e.g., liver, lungs). Treatment is more complex and may focus on control rather than cure, though newer therapies can extend and improve quality of life.

The stage at diagnosis largely determines the intensity of treatment, side effects, and long‑term outlook. This is why doctors emphasise not waiting for severe pain or dramatic symptoms before seeking help.


Colonoscopy room showing equipment used for colorectal screening
Screening tests such as colonoscopy can detect — and often remove — precancerous polyps before they turn into cancer.

Key tests to investigate concerning bowel symptoms

If you have persistent bowel changes or bleeding, your doctor may suggest one or more of these evidence‑based tests:


  1. Physical examination and history: A detailed discussion of your symptoms, diet, medications, and family history, along with an abdominal and rectal exam.
  2. Stool tests: These can check for hidden blood or abnormal DNA shed by tumour cells. They are usually used for screening, but may also guide further tests.
  3. Blood tests: To look for anaemia, inflammation, or tumour markers (such as CEA, though this alone is not diagnostic).
  4. Colonoscopy: A flexible camera examines the entire colon and rectum. Polyps can be removed and suspicious areas biopsied during the same procedure.
  5. Imaging: CT scan, MRI, or ultrasound may be used to stage the disease or rule out other causes of symptoms.


Everyday steps to support a healthier colon

No lifestyle change can guarantee you will never develop colorectal cancer, but research consistently shows that certain habits can lower risk and support overall gut health.


1. Build a fibre‑rich, plant‑forward plate

  • Aim for at least 25–30 grams of fibre daily from fruits, vegetables, whole grains, legumes, nuts, and seeds.
  • Gradually increase fibre with adequate water to avoid bloating.
  • Limit highly processed foods and sugary drinks, which can disrupt gut bacteria.

2. Moderate red and processed meats

Studies have linked high intake of processed meats (sausages, bacon, some deli meats) and large amounts of red meat to a higher risk of colorectal cancer. You do not need to become vegetarian overnight, but:

  • Keep processed meats as occasional treats, not daily staples.
  • Balance red meat with fish, pulses (daal, beans), and plant proteins.

3. Move more, sit less

Physical activity helps regulate bowel movements, manage weight, and reduce inflammation. Even with a desk job, you can:

  • Stand or walk for a few minutes every hour.
  • Aim for at least 150 minutes of moderate activity per week (like brisk walking).
  • Use stairs where possible and incorporate light stretching breaks.

4. Avoid smoking and limit alcohol

Both smoking and heavy alcohol consumption have been associated with higher colorectal cancer risk. If quitting feels daunting, consider professional support or cessation programmes.


Healthy plate with vegetables and whole grains supporting good gut health
A fibre‑rich, colourful plate supports a healthier gut environment and more regular bowel movements.


Overcoming common obstacles to getting checked

Knowing the signs is one thing; acting on them is another. Many people hesitate to seek help for bowel issues. If this sounds familiar, you are not alone.


“It’s embarrassing to talk about”

Discussing stool, bleeding, or bowel habits can feel uncomfortable, even with a doctor. Remember: healthcare professionals talk about these issues every day. For them, it is simply vital medical information.


“I’m too busy to go to the doctor”

Work and family responsibilities often push health to the bottom of the list. Yet a delayed check‑up can translate into more complicated treatment later. Think of an evaluation as an investment in being there, healthy, for the people who rely on you.


“I’m scared they’ll find something”

Fear is natural. But not knowing does not protect you — it only removes options. If there is a problem, catching it early almost always gives you more choices, less aggressive treatment, and better odds.



When should you see a doctor about bowel changes?

While occasional constipation or loose stools are usually harmless, you should arrange a medical review if:

  • Changes in bowel habits last more than 2–3 weeks
  • You see blood in your stool, on the toilet paper, or in the bowl
  • You feel a persistent need to pass stool, even after going
  • You experience unexplained weight loss, fatigue, or anaemia
  • You have a family history of colorectal cancer or polyps

If you are 45 or older, many international guidelines now recommend discussing routine colorectal cancer screening with your doctor — even if you have no symptoms.


Person consulting with a physician about colorectal cancer screening options
An honest conversation with your doctor about symptoms and risk factors is the first step towards timely diagnosis and peace of mind.

Evidence and further reading

For those who like to dive deeper, these reputable organisations provide up‑to‑date, evidence‑based information on colorectal cancer signs, screening, and treatment:



Listening to your gut: a gentle but urgent reminder

Constipation, sudden changes in bowel habits, or blood in the stool are easy to minimise — especially when life is busy and you feel “too young” for serious illness. Yet, as stories like Pattnaik’s remind us, these symptoms can sometimes be the earliest, most treatable signals of colorectal cancer.


You do not need to live in fear of every stomach cramp. But you do deserve to take your body’s messages seriously. If something feels “off” in your gut and it is not settling, let this be your nudge to book that appointment, ask the uncomfortable questions, and, if recommended, go for screening.


Your action today — making a call, scheduling a check‑up, or sharing this information with someone you care about — could be the difference between catching a problem early and facing it too late.