Rectal bleeding or changes in bowel habits can be concerning. While often due to benign issues like hemorrhoids, these symptoms can also indicate colon cancer. Understanding the distinctions is important for recognizing when medical attention is necessary.
What Are Hemorrhoids?
Hemorrhoids are swollen, inflamed veins in and around the anus and lower rectum. Common, affecting about half of all people by age 50, they can be internal or external. Increased pressure, often from straining during bowel movements, prolonged sitting, or chronic constipation/diarrhea, causes them, as do pregnancy and childbirth.
Symptoms include bright red blood on toilet paper, in the toilet bowl, or mixed with stool. This bleeding is typically painless. Other symptoms can involve itching, irritation, discomfort, or a lump near the anus. External hemorrhoids may be sore or tender, while internal ones are usually painless unless prolapsed or clotted.
What Is Colon Cancer?
Colon cancer originates in the large intestine, the final section of the digestive tract. It commonly begins as non-cancerous polyps on the colon’s inner lining. Over time, some polyps can become cancerous, a process taking several years.
Symptoms vary and may not be obvious early on. When present, they often include persistent changes in bowel habits like new-onset constipation or diarrhea, or narrowed stool. Rectal bleeding or blood in the stool is another common sign, appearing darker or mixed within the stool.
Other indicators include persistent abdominal discomfort (cramps, gas, pain), unexplained weight loss, or ongoing fatigue/weakness (sometimes due to anemia). Risk factors include increasing age, family history, inflammatory bowel diseases, and lifestyle factors like diet, obesity, and inactivity.
Differentiating Symptoms
While both hemorrhoids and colon cancer can cause rectal bleeding, blood presentation differs. Hemorrhoidal bleeding is typically bright red, appearing on toilet paper, dripping, or streaking stool, indicating origin near the anus. Colon cancer blood may be darker red or black, sometimes mixed within stool, suggesting bleeding from higher in the digestive tract.
Pain is another differentiator. Hemorrhoids can cause pain, especially external or thrombosed ones, but internal hemorrhoid bleeding is often painless. Colon cancer, early on, may not cause pain, but persistent abdominal discomfort, cramping, or gas can occur as it progresses.
Changes in bowel habits also vary. Hemorrhoids might cause temporary changes related to straining or discomfort. Colon cancer, however, can lead to persistent and progressive alterations like unexplained diarrhea or constipation lasting weeks, or a feeling of incomplete bowel emptying. Unexplained weight loss and fatigue are rarely associated with hemorrhoids (unless severe anemia), but are more commonly linked with advancing colon cancer.
When to See a Doctor
Seek professional medical evaluation for any persistent or concerning bowel symptoms, as self-diagnosis is misleading. Rectal bleeding, regardless of color or amount, warrants a healthcare provider visit to determine its cause. While hemorrhoids are a common source, serious conditions like colon cancer also present with this symptom.
Prompt medical attention is crucial for bowel habit changes lasting over a few weeks, such as new constipation, diarrhea, or altered stool. Persistent abdominal pain, cramps, or gas that do not resolve also require evaluation. Unexplained weight loss or ongoing fatigue without cause are additional signs for consultation. Early colon cancer detection significantly improves treatment outcomes, highlighting timely diagnosis.