March 31 is celebrated worldwide as World Colon Cancer Day. World Colon CancerDayThe aim is to raise public awareness of the needs of patients suffering from this disease and of the importance of prevention campaigns and early diagnosis.

According to the SEOM (Spanish Society of Medical Oncology), colon cancer will be the second most diagnosed cancer in Spain in both men and women, behind prostate and breast cancer, respectively. Thus, colorectal cancer is the most common cancer in Spain, with an estimated 44,000 cases. higher incidence in our countryThe number of colorectal cancers is estimated at almost 44,000 diagnoses by 2021.

The quality of life and life expectancy of colon cancer patients has greatly improved in recent years, especially thanks to screening programs and the elimination of risk factors. Even so, much remains to be done and the approach to colon cancer continues to advance.

Risk factors in colon cancer

There are different risk factors that are not avoidable, such as the agethe genetic predispositionor having had adenomatous polyps, previous colorectal cancer, inflammatory bowel disease o type II diabetes non-insulin dependent.

However, there are also risk factors associated with unhealthy lifestyle habits that can be avoided. Thus, it is recommended to reduce or eliminate the consumption of alcohol and tobacco, which

 have been shown to increase the risk of developing polyps in the colon mucosa. Sedentary lifestyles and obesity should also be avoided. In the case of food, a diet rich in fiber (fruit and vegetables), calcium and vitamin D (dairy products, nuts, legumes, oily fish) is recommended, as they can act as protectors against colon cancer.

SIBO and colorectal cancer

Recent studies have shown that there is a close relationship between the bacterial overgrowth (SIBO) and colon cancer. Thus, it has been seen that in patients with colon cancer there is a higher prevalence of SIBO than in healthy individuals, and it is also associated with the use of proton pump inhibitors. It is also known that postoperative changes in the anatomical structure of the intestinal tract provide the microbiota with an excellent breeding ground for the development of SIBO.

In addition, one of the papers demonstrated that probiotic intervention helps to alleviate gastrointestinal symptoms and reduce SIBO in patients with colorectal tumors. However, it is not known whether SIBO is pre-existing to the development of colorectal cancer and whether it is a risk factor, or rather a consequence of the surgeries and treatments that these patients undergo.

It is therefore essential to perform a early diagnosis of SIBO to improve intestinal health and prevent the development of other pathologies (such as permeability, inflammation, alterations of the immune system, favoring the development of tumors, etc.), but it is especially relevant in patients with colorectal cancer, since its treatment can improve digestive symptoms and favor the patient's recovery, especially after surgery.

 

1. Effect of probiotics on small intestinal bacterial overgrowth in patients with gastric and colorectal cancer. Liang S et al. Turk J Gastroenterol 2016; 27(3):227-232.
2. The study on small intestinal bacterial overgrowth in three kinds of digestive malignant Wei V et al. J Med Rev 2011; 17: 946-947.
3. The study on association between small intestinal cancer and small intestinal bacteria over-growth along with its clinical meanings. Yang L et al. WCJD 2013; 31: 3435-3439.
4. Prevalence and treatment of small intestinal bacterial overgrowth in postoperative patients with colorectal cancer. Deng L et al. Mol Clin Oncol 2016;4(5):883-887.