Find out about the bowel and problems that can sometimes occur with the bowel when you have cancer.

What is the bowel?

The bowel is the lower part of the digestive system. The digestive system is also called the gut or gastrointestinal tract (or the GI tract or GIT for short). 

The bowel goes from the stomach to the back passage (anus). It is a hollow muscular tube. It processes all the food we eat and breaks it down into nutrients for the body to use. It also gets rid of any solid waste matter from the body as poo (also called faeces or stools).

The bowel is divided into the small bowel (or small intestine) and the large bowel (colon and rectum). 

Most of the bowel problems caused by cancer are related to the large bowel. It is less common to get problems related to the small bowel.

What affects the bowel

How your bowel works is affected by a number of different things:

Muscles and nerves

The nerves and muscles in your back passage help you have normal bowel movements. So if treatment or illness damages these nerves or muscles, you might have some difficulty passing your poo.

The muscles in your tummy (abdomen) and your intestinal muscles also play a part in moving the poo down into your rectum.

Eating and drinking

What you eat affects your bowel motions. Eating a diet high in fibre with lots of fresh fruit and vegetables helps to keep your poo soft and regular.

Remember to drink plenty of water if you are eating more fibre. Fibre draws water into the bowel so you could get dehydrated if you don’t drink enough.

You need a certain amount of fluid in your body for your bowel to work properly. If you don’t have enough fluid you can get dehydrated. This can make it difficult to pass poo. So it is important to drink plenty of water (about 6 to 8 glasses) of water each day.

Exercise

A lack of daily exercise can reduce the muscle tone in your abdomen and bowel (intestines). This slows down the movement of poo through the gut. So taking regular exercise helps to keep your bowel working properly.

Ways of increasing daily exercise could include using the stairs rather than the lift, or getting off the bus one or two stops early.

Age

As we get older, the way our bowel works tends to change. Bowel problems are more common in older people. As we age we can become less active and our diet may change. This can have an impact on bowel function.

Other conditions

Conditions other than cancer can change the way your bowels work. This can include inflammatory bowel disease, piles (haemorrhoids) and infections. With the right treatment, your doctor can usually help control these conditions. 

What is a normal bowel habit?

How often you have a bowel movement can vary from person to person. Normal for some people can mean having a poo a few times a day, for others it might mean having a poo a few times a week. 

You can usually think of your bowel habit as normal if you:

• have regular bowel movements (not necessarily once a day)
• don’t have ongoing symptoms of constipation or diarrhoea
• can have a bowel movement without straining or using laxatives

How cancer treatment affects the bowel

Constipation and diarrhoea are common side effects of many drugs used as cancer treatments. Your doctor or nurse will talk to you about the side effects of any new drugs they prescribe for you.

Radiotherapy to the pelvic area or to the back passage (rectum) can cause diarrhoea. This usually comes on shortly after the treatment starts and lasts for a few weeks after the course of treatment ends. Your doctor or nurse might give you medicines to slow down your bowel and try to prevent diarrhoea.

Let your medical team know if you notice any of these side effects. They will be able to give you advice about how to treat them.