Pain in colon cancer
Pain is almost non-existent in the early stages of colorectal cancer and only occurs under certain conditions in the final stages: In the early stages, symptoms such as abdominal cramps can occur due to constant flatulence (bloating), proliferation in the intestinal lumen, and frequent diarrhea. However, cramp-like abdominal pain can also occur independently of food intake and bowel movements. Constipation can go so far that the person affected is unable to evacuate for several days.
This causes unpleasant abdominal pain and cramps. In the final stage, colon cancer is more complicated. The constant pressure on the intestinal wall can lead to perforation of the wall and emptying of the intestinal contents into the abdominal cavity.This inevitably leads to inflammation of the peritoneum, also called “peritonitis“.
The result is an “acute abdomen“, an extremely painful and pressure-sensitive abdomen with a “board-hard” defence mechanism. The mortality rate in such cases is up to 50%. As already mentioned, in the late stages of colorectal cancer, metastases can spread to the liver, which can also cause pain in the right upper abdomen.
The pain can be controlled with a step-by-step scheme developed by the WHO. While painkillers from the NSAID group, such as ibuprofen and Aspirin®, are initially given, low-potency opioids are used in the second stage of the staged scheme. Representatives of this group include Tilidine and Tramal®.
If even these drugs are not sufficient to effectively combat the pain, strong opioids such as fentanyl and morphine are used in the third stage. Here, some patients express some concern about the potential addiction associated with strong opioids. It is therefore necessary to carefully consider whether long-term opioid therapy should be given.
In any case, the opioid must be withdrawn in a controlled manner. Withdrawal symptoms only occur in isolated cases (less than 0.03%).
