The woman’s mother had colorectal cancer at the same age, so this diagnosis should be considered even though there has been no progression of symptoms or development of alarm features and recent colonoscopies have been normal.
Jean is a 57-year-old woman who is still concerned about a change in her bowel habit despite having had a couple of normal colonoscopies. She has been experiencing diarrhoea in the mornings for about the past five years. She wakes with the urge to defaecate, and subsequently has to open her bowels three or four further times before she leaves for work. The rest of the day is normal, although sometimes she needs to open her bowels a couple more times during the day. The stools are soft but formed, and there has been no blood or mucus and no pain. Most of her life she has had a ‘normal’ pattern of once daily defaecation after breakfast.