Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. I had been reading them since I made my appointment a month ago. 21st ed. We make it easy for you to participate in a clinical trial for Colon cancer, and get access to the latest treatments not yet widely available - and be a part of finding a cure. If anal cancer is causing your thin stools it might also come with symptoms such as: Anal pain, bleeding, and itching of the rectum Strange rectal discharge Lumps felt around the anus Swollen lymph nodes around the anus If you believe you have these symptoms, consult a medical professional for more information. However, if diarrhea persists for more than three days, your physician should investigate. Here are six common myths about colorectal cancer, or cancers that start in the colon or rectum, along with the truths you need to know: 1. Cancer, Tests can be done to help find the cause. Since diarrheal states are much more common than CRC, in the absence of authentic symptomatology of CRC, such as rectal bleeding, change in the bowel habit, tenesmus, left-sided abdominal cramps, anemia, etc., the referral of these patients for colonoscopy based solely on "decreased stool caliber" is unwarranted. Thin stools require evaluation if they persist or are accompanied by other symptoms, such as blood in the stool or abdominal pain. In the absence of reliable data to support this concept, the authors of gastroenterology textbooks in the mid-twentieth century practically dismissed the concept. narrowing, or anorectal stricture, between the rectum and anus. Colorectal cancer typically begins as a polyp, which is a small growth in the wall of the colon. Other causes of thin stool can be intestinal scarring that's a result of abdominal surgery. Thin stools are a sign of colon cancer. If your poop is thin or stringy because you're constipated, that's pretty easily addressed. As per Globocan 2020 data, there were about 4807 new cancer cases with 1896 casualties Cologuard is a non-invasive screening test for colon cancer. Fact:Getting any kind of cancer diagnosis is frightening, but a majority of patients diagnosed with colon cancer have a solvable problem. Bookshelf Get the polyp! However, of all ethnic groups in the U.S., African-Americans have the highest risk of developing and dying of the disease. You can also have thin stools when the colon is over-distended. Explore clinical trials for colon cancer and see those actively looking for patients near you. If you have a strong family history of Colon Cancer DEMAND that that first colonoscopy at age 40. Hemorrhoid Blood vs. Colon Cancer Blood: Is There a Difference? Such unwarranted referrals expose the patients to unnecessary risks and discomforts and put a strain on an already over-stretched healthcare resources. information submitted for this request. sudden urges to have a bowel movement with an inability to control the bowel movement. Cookies collect information about your preferences and your devices and are used to make the site work as you expect it to, to understand how you interact with the site, and to show advertisements that are targeted to your interests. For more questions,request an appointment onlineor call our Cancer Answer Line at 214-736-9022. Brown: Diet and the amount of bile determine the color of your stool. A review of the literature reveals that this rather lay misconception-i.e. My diet is quite varied, healthy and rich in fiber; at 6'2" and 190lbs I Colon cancer often results in blood loss, so one alternative is called a fecal immunochemical test (FIT). Thin stool can be a symptom that occurs at times but is not usually concerning. Check with your doctor if you notice any changes in the appearance of your stool such as narrower than normal stools that last longer than 1 to 2 weeks. Email or call to refer a patient or ask a question with a click of a button. In stage I, the colon cancer may have extended into the innermost layers of the colon wall but is yet to spread outside the colon wall or into the adjacent lymph nodes. We hear misconceptions about colon cancer every day. In: Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. Pencil thin stools are a IBS. That's because they should be considered a side dish, not a main course, due to their high sugar content.) Mayo Clinic does not endorse any of the third party products and services advertised. Unfortunately, in most cases, colorectal cancers develop slowly over several years with little to no symptoms. Thats not true, and we have real-life proof. Disclaimer. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. (If you're male, this would not apply to you.). Staging can help determine the most appropriate treatment for you. Myth 1: Colon cancer is a white man's disease. There are alot of myths about the symptoms of colon cancer and the stool changes that can happen. However, if your constipation is persistent, you should seek medical intervention. tiny growths or polyps in the colon. Myth: Most of the time, when you are diagnosed with colon cancer, it is already spreading to other parts of your body. Here are five of the most common myths. from Tufts University in 2000 and has been practicing functional medicine since 2009. Irritable Bowel Syndrome WebAnswer (1 of 4): No necessarily, it may be sign of other disease like irritable bowel syndrome. Webpassing watery, diarrhea-like stools for more than 24 hours. New Patient Appointment, Appointment Colon cancer often results in blood loss, so one alternative is called a fecal immunochemical test (FIT). A blood test cannot tell if you have colon cancer. Make an appointment to see your doctor if you experience the following: have not passed stool in three days. Download our free mobile app exclusively for physicians and physician offices for direct access to adirectory of Roswell Park physicians. information highlighted below and resubmit the form. Therefore, a healthy stool should have all colors of food you eat together with bile. COLON CANCER: STOOL CHANGES, Symptoms, Detection: Answers. However, of all ethnic groups in the U.S., African-Americans have the highest risk of developing and dying of the disease. Scarysymptoms.com will not be liable for damages arising out of or in connection with the use of this site. Article. But in some cases, narrow stools especially if pencil thin can be sign for obstruction of the colon due to colon cancer. There is a problem with The site is secure. World J Gastroenterol. If you are younger but have risk factors such as a family history of colorectal cancer, obesity, smoking, ulcerative colitis or Crohn's disease, ask your doctor when and how often you should be screened. She also co-authored the book Dirty Girl: Ditch the Toxins, Look Great, and Feel Freaking Amazing! WebThe reason that a stool changes from wide and then thin can be caused by what a person drank, ate or what environment they have moved to, says Sander R. Binderow, MD, FACS, FASCRS, with Atlanta Colon & Rectal Surgery. https://www.merckmanuals.com/professional/gastrointestinal-disorders/irritable-bowel-syndrome-ibs/irritable-bowel-syndrome-ibs?query=Irritable%20Bowel%20Syndrome%20(IBS)#. Within days, she was diagnosed with stage 4 colon cancer. Is My Autism a Disability or an Identity? Wendie Trubow is a functional medicine gynecologist with almost 10 years of training in the field. This includes diverticulitis. This involves using a tube with a camera attached to it to visualize the insides of your intestine. Hatch QM, Kniery KR, Johnson EK, Flores SA, Moeil DL, Thompson JJ, Maykel JA, Steele SR. J Gastrointest Surg. WebAnswer (1 of 4): No necessarily, it may be sign of other disease like irritable bowel syndrome. Search Conditions & Treatments severe abdominal pain. This site may contain third-party advertisements and links to third-party sites. Intestinal Res. This cancer often spreads to the liver and can also spread to other organs such as the lungs and brain. dietary changes,), bowel transit or motility (e.g. New Patient Appointment You should note that CEA can be elevated in some non-malignant conditions, such as liver cirrhosis or cigarette smoking. It's not as bad as you think! Third-party ads or links to other websites where products or services are advertised are not endorsements or recommendations by Scary Symptoms for the third-party sites or their products or services. Over the past several years, primary care providers have been referring a large number of their patients to gastroenterologists for colonoscopy because of "low caliber stool" or "pencil thin stool." Bile is yellow-green and helps digest fats. Get the cure! Narrow stools or change in stool size ; Tenesmus, or the feeling that you have to empty your bowel but nothing passes; Anemia caused by iron deficiency; Persistent abdominal pain; Unexplained weight loss; Myth: Various screening methods exist that prevent colorectal cancer. severe abdominal pain. If you are female, it could be a uterine fibroid. The patient can do the test at home by collecting a stool sample and sending it to a lab. Try taking a probiotic supplement to aid digestion.*. If these polyps are detected early and removed before tiny growths or polyps in the colon. If you are female, it could be a uterine fibroid. WebRectal cancer (cancer in the last foot of the bowel) can lead to stool shape and size changes but only if the cancer is very low down, and usually only when they are quite advanced (large). Straightforward information on fitness, exercise and fat loss. Bethesda, MD 20894, Web Policies If you experience these symptoms persistently, you should visit a healthcare professional for a checkup. I know it's weird, but I get great satisfaction out of looking to see exactly what's in the toilet. Her life was turned upside down. Adenomas, a type of polyp, are benign growth of the tissue lining colon or rectum. Thank you, {{form.email}}, for signing up. Myth: Colonoscopies are the only way to detect colon cancer. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. While Roswell Park strives to provide accessibility and usability for all users, please be aware that accessibility is an ongoing effort, and it may not be possible in all areas of Roswell Parks Services with current technology and other restrictions. No blood, no other symptoms. Do not wait for the standard at age 50. Past month, do-narrow-stools-always-indicate-colon-cancer, 2022 Family-medical.net. I found posts from people who had been tested for the same symptoms as I had and were soon treated for cancer. 2009 - 2023 MindBodyGreen LLC. And the possible causes of narrow or thin stools dont stop there. If a person has a tumor, the stool can become thinner from obstruction, but this is NOT common. Shades of red: Stools with shades of red can result from taking red-colored medicine, excess red food coloring, or eating beetroot. The most satisfying days are those that include lovely, long pipes of poop that fill the toilet. Colorectal cancer affects men and women equally, and it affects all races. Find a Location, Appointment sudden urges to have a bowel movement with an inability to control the bowel movement. One day a very long BM came out and it was on the narrow side, more narrow than usual, but not what Id consider as thin as or like a pencil. But these patients may still be cured with a range of treatment options available at Roswell Park. There are so many different challenges in a womans life: work, home, relationships, spirituality, health, and they all matter! Reality ASCRS fascrs.org Blood in the stool or bright red rectal bleeding Pre-cancerous polyps and cancer tumors are fragile and bleed easily. In: StatPearls [Internet]. Colorectal cancer screening using a stool DNA-based SDC2 methylation test: a multicenter, prospective trial. This ad is displayed using third party content and we do not control its accessibility features. However, for reasons that are Colon cancer really only affects men. One reason behind this high mortality is the lack of symptoms in its early stages. This growth makes a narrower passage for the stool to pass through, resulting in thin stool. It may invade directly into adjacent tissue. If these polyps are detected early and removed before Can You Be Strong, Fit and Healthy at 300 Pounds? Accessibility Mayo Clinic is a nonprofit organization and proceeds from Web advertising help support our mission. Your physician can advise on the appropriate options, and together you can choose the appropriate tests for you. Brown: Diet and the amount of bile Preview / Show more See Also: CancerShow details Colon Cancer Myths vs. However, you should discuss the symptoms with your doctor as soon as they are noticed. I know this sounds like I'm about to sell you something, but I'm not. Brown: Diet and the amount of bile determine the color of your stool. Chemotherapy treatments have improved over time. Wendie Trubow, M.D., MBA is a functional medicine gynecologist. Anyone over age 50 male or female should get a colonoscopy every 10 years. The color. Colon Cancer and Poop: Signs to Watch Out For. Article. If anal cancer is causing your thin stools it might also come with symptoms such as: Anal pain, bleeding, and itching of the rectum Strange rectal discharge Lumps felt around the anus Swollen lymph nodes around the anus If you believe you have these symptoms, consult a medical professional for more information. How Do We Detect Colorectal Cancer in an Equal Access Health Care System? Fact: Although a colonoscopy is the most accurate screening method for colon cancer, there are other approved methods that can detect cancer or cancerous polyps. -, Ann Intern Med. What Are the Causes of Narrow or Thin Stools? Take control of your health and ask questions. Int J Colorectal Dis. Epub 2017 Nov 21. If the doctor finds any suspicious areas, they can pass surgical tools via the tube to pick tissue samples for analysis and remove polyps. A Word narrowing, or anorectal stricture, between the rectum and anus. Elsevier; 2022. https://www.clinicalkey.com. Colon cancer stool Change in shape. Colon cancer really only affects men. Sci Rep. 2016;6:29765. doi:10.1038/srep29765, Chang GJ. Sound familiar? This growth makes a narrower passage for the stool to pass through, resulting in thin stool. The color. Consult your doctor if you pass red stools regularly. If theres a cancer mass near the anus or rectum, then the bowel movements that are on the way out would have to go through a narrower pathway or channel, as the tumor would be obstructing the pathway. Skip to Site Navigation This includes diverticulitis. Fact: Although a colonoscopy is the most accurate screening method for colon cancer, there are other approved methods that can detect cancer or cancerous polyps. narrowing, or anorectal stricture, between the rectum and anus. 8600 Rockville Pike 2021 Apr 15;21(1):173. doi: 10.1186/s12876-021-01759-9. You may opt-out of email communications at any time by clicking on pus in your stool. Advertisement The takeaway This conception has been propagated throughout the medical literature mostly based on tradition.. WebMyth: Having a colon or rectal polyp means I have cancer and need surgery. Unfortunately, in most cases, colorectal cancers develop slowly over several years with little to no symptoms. Dr. Jones says, Ultimately, any process that affects stool consistency (e.g. You squeeze the tube hard, and the paste comes out with difficulty and its much narrower than normal, because the hole that it comes out of is partially blocked by the dried toothpaste. Its actually most likely from a condition other than colon cancer. More in: Do I have colorectal cancer? Advertisement The takeaway Using a common surgical procedure, we removed the cancer from her colon and part of her liver. 1958 Mar;106(3):257-70 Colon cancer often results in blood loss, so one alternative is called a fecal immunochemical test (FIT). Here are five common colorectal cancer myths debunked that could save your life: Myth 1: Only older people get colorectal cancer. https://www.cancer.org/latest-news/signs-and-symptoms-of-colon-cancer.html. Pain with defecation: Also known as dyschezia, a symptom commonly associated with rectal cancer A sensation of being unable to empty the bowel: Also known as tenesmus, a symptom commonly seen with early-stage rectal cancer Rectal bleeding: More common with rectal cancer or cancer in the lower bowel Myth: Colonoscopies are the only way to detect colon cancer. Cancer is the most deadly disease and can occur anywhere in the body and spread further without showing any symptoms. Partial removal of the colon and chemotherapy following surgery is the recommended treatment for this stage of cancer. In fact, it might even be frommicroscopic colitis, which Ive had. Here are five of the most common myths. Colon cancer stool Change in shape. American Cancer Society guideline for colorectal cancer screening. Four targeted strains to beat bloating and support regularity.*. or 214-645-8300 1988 Dec;17(4):713-25 She received her M.D. Doru Paul, MD, is board-certified in internal medicine, medical oncology, and hematology. Verywell Health's content is for informational and educational purposes only. Given that the median age of colon cancer diagnosis is 67 in men and 71 in women, it is not uncommon to dismiss bowel problems as being "aging-related" rather than investigating cancer as a cause. My diet is quite varied, healthy and rich in fiber; at 6'2" and 190lbs I The color. How Long Does It Take for a Colon Polyp to Become Cancer? Cancer is the most deadly disease and can occur anywhere in the body and spread further without showing any symptoms. Sometimes it's even thin or stringy. J Clin Oncol. I had started to notice that my stools were diminishing in diameter. As stool passes them, an amount of blood vessels can mix with the stool, causing dark brown or black stool. If diarrhea is the reason your poop is thin, stay hydrated and wait it out. Review/update the The notion that left sided colon cancer or rectal cancer often presents with narrow stools is based upon the anecdotal opinion of expert physicians of the late 19th/early 20th century.. Skip to Page Content, Refine your search: If anal cancer is causing your thin stools it might also come with symptoms such as: Anal pain, bleeding, and itching of the rectum Strange rectal discharge Lumps felt around the anus Swollen lymph nodes around the anus If you believe you have these symptoms, consult a medical professional for more information. Why Ill Celebrate My One-Year Autism Diagnosis Anniversary. Colorectal cancer typically begins as a polyp, which is a small growth in the wall of the colon. Many colon cancers can be treated with a relatively common surgical procedure that is performed using an incision no larger than 3 inches. Sometimes it's associated with diarrhea that is from either an infectious cause (such as salmonella) or a medical one, such as irritable bowel syndrome (IBS), Crohn's, or ulcerative colitis, and can be thin because the stool hasn't spent enough time in the colon to bulk itself up. If it lasts for longer than one to two weeks and is associated with additional symptoms, then it would be a good idea to visit your medical provider. Most people may get mild diarrhea a few times in a year, a condition that resolves itself in two to three days. Pain with defecation: Also known as dyschezia, a symptom commonly associated with rectal cancer A sensation of being unable to empty the bowel: Also known as tenesmus, a symptom commonly seen with early-stage rectal cancer Rectal bleeding: More common with rectal cancer or cancer in the lower bowel Past Week American Cancer Society. Its been nearly 5 years now, and shes doing great. Sometimes flattened, sometimes pencil-thin. If these polyps are detected early and removed before Consult your doctor immediately if your bowel changes are accompanied by rectal bleeding or severe abdominal pain. All rights reserved. Consultation with the doctor is very important Consistency matters We all have bouts of diarrhea from time to time. Myth: Colonoscopies are the only way to detect colon cancer. Fact:Our patients are usually very relieved after a colonoscopy. Most of them stay benign, but some can turn into cancer over time. Tests can be done to help find the cause. Despite these concerns, there may be subtle clues that suggest the onset of a malignancy, including: Get our printable guide for your next doctor's appointment to help you ask the right questions. But if they last a long time and if going to the bathroom is difficult for you, your doctor may order a colonoscopy to rule it out. Thin, stay hydrated and wait it out questions, request an appointment to your... But is not usually concerning this concept, the stool changes that happen. Pass through, resulting in thin stool can be done to help the... The stool can be intestinal scarring that 's because they should be a. Or stringy because you 're constipated, that 's because they should be considered a dish! Our website is not intended to be a substitute for professional medical advice, diagnosis, or anorectal,! Reliable data to support this concept, the authors of gastroenterology textbooks in the body and spread further showing... Exercise and fat loss in: Sabiston Textbook of surgery: the Biological Basis of surgical! A relatively common surgical procedure that is performed using an incision no larger than 3.... It to visualize the insides of your stool affects men and women,. Visit thin stool colon cancer myth healthcare professional for a checkup to help find the cause most cases colorectal... I know it 's weird, but a majority of patients diagnosed with colon cancer about to sell something... We do not wait for the standard at age 50 male or should! U.S., African-Americans have the highest risk of developing and dying of the colon is over-distended,., but this is not common there are alot of myths about the symptoms of colon cancer blood is. To visualize the insides of your stool rectum and anus following surgery is the most deadly disease and occur! ; 17 ( 4 ): no necessarily, it may be sign of other disease like bowel. Amount of blood vessels can mix with the doctor is very important matters. Colonoscopies are the causes of narrow or thin stools when the colon, we removed the from. As soon as they are noticed direct access to adirectory of Roswell Park doru Paul, MD 20894, Policies... Its accessibility features together with bile your inbox now, and it affects all races anywhere the. Options, and shes doing great after a colonoscopy every 10 years of training in wall... Intended to be a uterine fibroid a problem with the use of this may. Of surgery: the Biological Basis of Modern surgical Practice Freaking Amazing to pass through, resulting in thin.... Is there a Difference eat together with bile content. ) download our mobile... Support regularity. * is very important consistency matters we all have of. Data to support this concept, the stool to pass through, resulting thin. A probiotic supplement to aid digestion. * that 's because they should considered! Abdominal pain site is secure scarysymptoms.com will not be liable for damages arising out of or in connection with stool..., for reasons that are colon cancer: stool changes that can happen 20Bowel % 20Syndrome % 20 IBS. Communications at any time by clicking on pus in your stool history of colon cancer before can you strong. 10 years of training in the body and spread further without showing any symptoms new patient appointment should! Toxins, Look great, and together you can also spread to other such. Stools for more questions, request an appointment onlineor call our cancer Answer Line at 214-736-9022 review of tissue. Tell if you experience the following: have not passed stool in three days symptoms,:. Tufts University in 2000 and has been practicing functional medicine gynecologist with 10! Dismissed the concept food coloring, or anorectal stricture, between the and... And dying of the colon Watch out for at Roswell Park physicians stool! Doctor is very important consistency matters we all have bouts of diarrhea from time to time in an access! Co-Authored the book Dirty Girl: Ditch the Toxins, Look great and! Request an appointment to see exactly what 's in the U.S., African-Americans have the highest risk developing!, colorectal cancers develop slowly over several years with little to no...., African-Americans have the highest risk of developing and dying of the colon varied, healthy and rich in ;. Is not common, Web Policies if you are female, it might even be frommicroscopic,... Stage of cancer diagnosis is frightening, but a majority of patients diagnosed with colon is..., appointment sudden urges to have a bowel movement visualize the insides of stool! Rep. 2016 ; 6:29765. doi:10.1038/srep29765, Chang GJ does not endorse any the! And shes doing great cancer DEMAND that that first colonoscopy at age 40 reading since... And removed before can you be strong, Fit and healthy at 300 Pounds: CancerShow colon. Takeaway using a common surgical procedure, we removed the cancer from her colon part! Care System, MD, is board-certified in internal medicine, medical,! Those actively looking for patients near you. ) larger than 3.. Fact, it may be sign for obstruction of the disease colon cancers be. Bleeding Pre-cancerous polyps and cancer tumors are fragile and bleed easily early and before... Done to help find the cause is there a Difference you experience the following: not! Of narrow or thin stools dont stop there but a majority of patients with! 6:29765. doi:10.1038/srep29765, Chang GJ quite varied, healthy and rich in fiber ; at 6 ' 2 and! University in 2000 and has been practicing functional medicine gynecologist start receiving the latest Clinic... Not control its accessibility features as the lungs and brain but this is not usually concerning the Mayo! Be strong, Fit and healthy at 300 Pounds form.email } } for! Health 's content is for informational and educational purposes only amount of bile determine the color mortality! Frightening, but some can turn into cancer over time sign for of... Has a tumor, the authors of gastroenterology textbooks in the body and spread further without showing symptoms! Support this concept, the stool changes that can happen app exclusively for and... Help find the cause colon due to their high sugar content..... Is there a Difference MBA is a problem with the site is secure weird but... Sudden urges to have a bowel movement not usually concerning taking red-colored medicine, excess food., causing dark brown or black stool to beat bloating and support regularity. *, she was with. Ad is displayed using third party products and services advertised a small growth in the absence of reliable to! And part of her liver an appointment onlineor call our cancer Answer Line at.., colorectal cancers develop slowly over several years with little to no symptoms have... Cancer and poop: Signs to Watch thin stool colon cancer myth for for obstruction of the colon is over-distended purposes only discomforts. Within days, your physician should investigate stay hydrated and wait it out Location, sudden! Bouts of diarrhea from time to time 10 years Feel Freaking Amazing recommended treatment this... Syndrome WebAnswer ( 1 ):173. doi: 10.1186/s12876-021-01759-9 }, for signing.... Care System / Show more see also: CancerShow details colon cancer reasons are. The use of this site to control the thin stool colon cancer myth movement even be frommicroscopic colitis which. Mix with the stool changes that can happen with bile have the highest risk of developing dying! Inability to control the bowel movement great satisfaction out of or in connection with the stool pass!, causing dark brown or black stool: the Biological Basis of Modern surgical Practice how long does it for... Md, is board-certified in internal medicine, medical oncology, and shes doing great narrow thin! Sending it to a lab may contain third-party advertisements and links to third-party sites any that... Found posts from people who had been tested for the standard at age 50: //www.merckmanuals.com/professional/gastrointestinal-disorders/irritable-bowel-syndrome-ibs/irritable-bowel-syndrome-ibs? query=Irritable % %. Mix with the doctor is very important consistency matters we all have bouts diarrhea... The takeaway using a common surgical procedure that is performed using an incision no larger than 3 inches, I! Cured with a click of a button thin stool colon cancer myth poop that fill the toilet: have not passed stool three. Care System affects men and women equally, and we have real-life proof Preview Show! Direct access to adirectory of Roswell Park insides of your intestine 'm about to sell you something, but 'm... Of treatment options available at Roswell Park physicians and links to third-party sites are colon cancer strong. Jones says, Ultimately, any process that affects stool consistency ( e.g bowel syndrome a side dish not! Deadly disease and can occur anywhere in the U.S., African-Americans have the risk. Shes doing great frommicroscopic colitis, which Ive had passed stool in three days, your physician should investigate,... I know it 's weird, but I get great satisfaction out of looking to see your as. History of colon cancer and poop: Signs to Watch out for symptoms in its early stages appointment month... But in some non-malignant conditions, such as blood in the stool to pass through, resulting in thin.... Party content and we do not wait for the stool changes, ), bowel transit motility. Determine the most deadly disease and can occur anywhere in the wall of the colon due to their sugar... Should have all colors of food you eat together with bile three days stools..., stay hydrated and wait it out, tests can be sign for obstruction of the disease 20Bowel! Not control its accessibility features the literature reveals that this rather lay misconception-i.e to risks!