Experiencing symptoms like rectal bleeding can be concerning, as they may indicate serious conditions such as colorectal cancer. While often caused by common hemorrhoids, understanding the distinctions between these conditions is important. This article provides general information on both, emphasizing the need for professional medical evaluation for an accurate diagnosis.
What Are Hemorrhoids?
Hemorrhoids are swollen veins located in the rectum or around the anus. They are a common condition, affecting approximately half of all adults by age 50.
There are two main types: internal, which form inside the rectum and are typically not visible; and external, which develop under the skin around the anus and may be felt or seen as small lumps. Common symptoms include bright red bleeding during or after bowel movements, itching or irritation around the anus, discomfort or pain, a feeling of fullness after defecating, or a discharge of mucus.
Factors contributing to hemorrhoid development include straining during bowel movements, chronic constipation or diarrhea, prolonged sitting, and pregnancy.
What Is Colorectal Cancer?
Colorectal cancer is a disease where cells in the colon or rectum grow uncontrollably. The colon is the large intestine, and the rectum is its final section before the anus.
This cancer often begins as small, noncancerous growths called polyps on the inner lining of the colon or rectum. While not all polyps become cancerous, some can develop into malignant tumors over time.
Symptoms can include changes in bowel habits, such as new or persistent diarrhea or constipation, and rectal bleeding. Other signs may involve abdominal discomfort, unexplained weight loss, and fatigue or weakness.
Key risk factors include increasing age, a family history of the disease, certain inflammatory bowel diseases, a low-fiber diet, and obesity.
Distinguishing Symptoms
While both hemorrhoids and colorectal cancer can cause rectal bleeding, distinctions exist in the nature of the bleeding and other accompanying symptoms. Hemorrhoid-related bleeding is typically bright red and occurs during or immediately after a bowel movement, often seen on toilet paper or in the toilet bowl. This bleeding is usually painless or associated with mild discomfort.
In contrast, bleeding from colorectal cancer can be bright or dark red, or even appear tarry, and may occur at any time, not necessarily tied to a bowel movement. The blood might also be mixed in with the stool.
Pain associated with hemorrhoids tends to be sharp or acute, localized around the anus, especially with external hemorrhoids due to more nerve endings in that area. Colorectal cancer, however, may cause more generalized abdominal pain, cramping, or a persistent feeling of incomplete bowel emptying.
Colorectal cancer can also present with systemic symptoms not typically associated with hemorrhoids. These include unexplained weight loss, persistent fatigue, and changes in the caliber of stool, such as stools becoming narrower or ribbon-like. While symptoms can overlap, the presence of these systemic signs often points toward a more serious underlying condition.
When to See a Doctor
Given the potential overlap in symptoms between hemorrhoids and colorectal cancer, seeking medical attention for any persistent or concerning rectal symptoms is important.
Any new rectal bleeding, especially if it is dark or mixed with stool, warrants prompt medical evaluation. Consult a healthcare provider if you experience unexplained changes in bowel habits, such as new onset of constipation or diarrhea, or a change in stool consistency that lasts for more than a few days.
Other symptoms that necessitate a doctor’s visit include persistent abdominal pain or cramping, unexplained weight loss, or ongoing fatigue without a clear cause.
If hemorrhoid-like symptoms do not improve with common home remedies after about a week, or if they worsen, a medical consultation is recommended. Only a qualified medical professional can perform a thorough examination and determine the true cause of your symptoms, providing an accurate diagnosis.
The Diagnostic Process
When you consult a doctor about rectal symptoms, they will begin with a detailed medical history and a physical examination. This may include a digital rectal exam (DRE), where the doctor inserts a gloved finger into the rectum to check for abnormalities.
The doctor might also recommend an anoscopy, which examines the anal canal, or a sigmoidoscopy, which visualizes the lower part of the colon. A colonoscopy is a more extensive procedure where a flexible tube with a camera is used to examine the entire length of the colon and rectum.
During these procedures, if any suspicious areas or polyps are found, a biopsy (tissue sample) can be taken for laboratory analysis to determine if cancer cells are present. Blood tests or stool tests may also be part of the diagnostic workup. An early and accurate diagnosis of colorectal cancer significantly improves treatment outcomes.