Straight answers to the questions people actually ask.

Is blood in the stool always cancer?

No. Most rectal bleeding is caused by haemorrhoids or an anal fissure. It needs a colonoscopy when the blood is mixed through the stool, when the bowel habit has changed for three weeks or more, when there is unexplained anaemia or weight loss, or when bleeding returns after treatment for piles.

Piles and a tumour can exist in the same patient, so finding haemorrhoids does not rule cancer out. If you carry any red flag, ask for a scope even after a piles diagnosis.

How long should a change in bowel habit last before I see a doctor?

Three weeks. A change in stool frequency, calibre, urgency or consistency that has not returned to your baseline within three weeks is the standard threshold for medical assessment in colorectal practice.

Can you get colorectal cancer under 50?

Yes. Early-onset colorectal cancer in people aged 30 to 49 has been rising for two decades and is often diagnosed later because symptoms are attributed to piles, IBS or stress. Persistent symptoms in a young adult justify a colonoscopy, not reassurance.

What are the warning signs of colorectal cancer?

Rectal bleeding, a bowel habit that changed and stayed changed beyond three weeks, a feeling of incomplete emptying, unexplained weight loss, unexplained iron-deficiency anaemia or persistent fatigue, and abdominal pain or bloating that keeps returning.

At what age should colorectal cancer screening start?

At 45 for people at average risk, using either an annual stool test (FIT) or a colonoscopy at longer intervals. With a first-degree relative affected, start at 40 — or ten years before their age at diagnosis, whichever comes first.

Does a colonoscopy hurt?

It is performed under sedation, so most people feel nothing during the procedure and have no memory of it. The preparation the day before — a laxative regimen and clear fluids — is the demanding part, not the test itself.

Plan for a half day, arrange someone to accompany you home, and expect to eat normally afterwards.

What is a FIT test and is it enough?

FIT detects hidden blood in stool and is a good annual screening test for people with no symptoms and no red flags. It is not sufficient when there is a palpable mass, anaemia, or persistent symptoms — those require a colonoscopy regardless of a negative FIT.

Will I need a permanent colostomy bag for rectal cancer?

Usually not. Most rectal cancers today are treated with sphincter-preserving surgery, often after chemoradiotherapy shrinks the tumour away from the anal sphincter. A temporary stoma for a few months is common; a permanent one is reserved for tumours directly involving the sphincter complex.

What is robotic colorectal surgery and why does it matter?

Robotic surgery gives the surgeon wristed instruments and magnified 3D vision inside the narrow pelvis. In rectal cancer this supports precise dissection along the correct tissue plane, better nerve preservation for bladder and sexual function, and a higher chance of preserving the sphincter.

How long is recovery after colorectal cancer surgery?

Most patients having minimally invasive surgery are walking the same day, discharged within three to six days, and back to light routine activity in two to four weeks. Recovery is longer if a stoma, open surgery or chemotherapy is part of the plan.

Who is Dr. Ritesh Anand?

Dr. Ritesh Anand is an MCh-qualified gastrointestinal and colorectal surgeon and Senior & Lead Colorectal Surgeon at Smiles Institute of Gastroenterology, Mathikere, Bengaluru. His practice focuses on robotic and laparoscopic colorectal cancer surgery, sphincter preservation and advanced proctology.

Where does Dr. Ritesh Anand consult and how do I book?

Consultations are at Smiles Institute of Gastroenterology, Mathikere, Bengaluru. Appointments can be made by phone or WhatsApp on +91 90714 19988.

Can I get a second opinion on a colorectal cancer plan?

Yes. Bring your colonoscopy and biopsy report, MRI rectum or CECT abdomen images, and any treatment plan already proposed. A second opinion most often changes the sequence of treatment or the feasibility of sphincter preservation, rather than the diagnosis.

Can another doctor discuss a case with Dr. Ritesh Anand?

Yes. A peer-to-peer case discussion line is open to fellow physicians for imaging reviews, staging questions and sphincter-preservation feasibility, with no obligation to transfer the patient's care.