Rectal symptoms can overlap between common conditions like hemorrhoids and more serious ones such as colon cancer. While hemorrhoids are a frequent and often benign issue, certain symptoms warrant professional medical evaluation to rule out serious diseases.
Hemorrhoids Explained
Hemorrhoids are swollen veins located in the anus and lower rectum, similar to varicose veins. They develop when increased pressure in the lower rectum causes these veins to stretch and bulge. Hemorrhoids can be categorized as internal, forming inside the rectum, or external, developing under the skin around the anus.
Common causes of hemorrhoids include straining during bowel movements, chronic constipation or diarrhea, prolonged sitting, and pregnancy. Symptoms often involve painless bleeding during bowel movements, where bright red blood might appear on toilet tissue or in the toilet bowl. Other signs may include itching or irritation around the anal area, pain, swelling, or a tender lump near the anus, especially with external hemorrhoids. Internal hemorrhoids may also prolapse, meaning they push through the anal opening, which can cause pain and irritation.
Colon Cancer Explained
Colon cancer originates in the large intestine, which is the final part of the digestive tract. This cancer often begins as small, non-cancerous growths called polyps on the inner lining of the colon. While not all polyps become cancerous, some can develop into malignant tumors over time.
Symptoms of colon cancer can be subtle in early stages and often depend on the cancer’s size and location. Common symptoms include persistent changes in bowel habits, such as new or more frequent diarrhea or constipation, or a change in stool consistency. Rectal bleeding or blood in the stool is another sign, though the appearance of the blood might differ from hemorrhoids. Other indicators can be ongoing abdominal discomfort like cramps or gas, unexplained weight loss, and persistent fatigue or weakness. Risk factors for colon cancer include older age, a personal or family history of colon cancer or polyps, inflammatory bowel diseases like ulcerative colitis or Crohn’s disease, and certain lifestyle factors such as a low-fiber, high-fat diet, lack of physical activity, obesity, smoking, and heavy alcohol consumption.
Distinguishing Symptoms
Rectal bleeding is a shared symptom between hemorrhoids and colon cancer. With hemorrhoids, the blood is typically bright red and appears on toilet paper or in the toilet bowl during or after a bowel movement. This bright color indicates the blood is fresh and likely from the lower part of the digestive tract. Bleeding associated with colon cancer may also be bright red if the tumor is low in the rectum, but it can also be darker or mixed with the stool, sometimes giving the stool a tarry appearance, indicating bleeding from higher up in the colon.
Beyond bleeding, other symptoms provide important clues. Hemorrhoid symptoms are often episodic and may resolve with home treatments, whereas colon cancer symptoms tend to persist and worsen over time. Persistent changes in bowel habits, such as a new onset of prolonged constipation or diarrhea, or a feeling that the bowel does not empty completely, are more characteristic of colon cancer. Unexplained weight loss, persistent abdominal pain or cramping, narrow stools, and unexplained anemia are also symptoms that point more strongly toward colon cancer. It is important to note that self-diagnosis based solely on symptoms can be misleading, and medical evaluation is necessary for an accurate diagnosis.
When to Seek Medical Advice
Any instance of rectal bleeding warrants a consultation with a healthcare professional. While often benign, blood from the rectum can signal a serious underlying condition, and a medical professional can determine the cause. It is particularly important to seek prompt medical attention if rectal bleeding is continuous or heavy, or if it is accompanied by severe abdominal pain or cramping.
Other “red flag” symptoms that necessitate a doctor’s visit include persistent changes in bowel habits lasting more than a few days, unexplained weight loss, ongoing abdominal discomfort, or the passage of very dark or black stools. Individuals with a family history of colon cancer or those over the age of 45 experiencing new or concerning symptoms should also seek timely medical evaluation. Early diagnosis of colon cancer significantly improves treatment outcomes.
Colon Cancer Screening
Colon cancer screening plays a crucial role in detecting precancerous polyps before they become cancerous and identifying cancer at an early, more treatable stage. For individuals at average risk, major health organizations generally recommend starting regular screening at age 45. Screening options vary and include stool-based tests, which detect hidden blood or abnormal DNA in stool, and visual examinations of the colon.
Common screening methods include a colonoscopy, which allows for a thorough examination of the entire colon and the removal of polyps during the procedure. Other options include fecal immunochemical tests (FIT) performed annually, or multitarget stool DNA tests, typically done every three years. The most appropriate screening method and schedule should be determined in consultation with a doctor, considering individual risk factors and preferences.